Predictive Value of VIBE using Subtraction to Evaluate Idiopathic Facial Palsy after Starting Therapy

Author:

Tomita Hayato12,Detmar Klaus1,Manava Panagiota1,Nakajima Yasuo2,Lell Michael13,Adamus Ralf3

Affiliation:

1. Radiology and Nuclear Medicine, Klinikum Nuernberg, Paracelsus Medical University, Nürnberg, Germany

2. Radiology, St. Marianna University School of Medicine, Kawasaki, Japan

3. Radiology, Erlangen University Hospital, Erlangen, Germany

Abstract

Purpose To determine the predictive value of 3-dimensional spoiled gradient-echo volumetric interpolated breath-hold examination (VIBE) using subtraction to evaluate the short-term effect of therapy for facial palsy. Materials and Methods We included 97 patients with idiopathic facial palsy (52 male, 45 female; aged 50.7 ± 19.4 years) who underwent MR imaging with a contrast agent after starting therapy. The mean interval between onset and therapy was 1.55 ± 1.69 days, between therapy and MR imaging was 3.19 ± 2.78 days, and between MR imaging and assessment of the therapeutic effect was 3.50 ± 0.71 days. The degree of therapeutic effect was determined using a 4-grade scale based on the House–Brackmann scale for grading facial nerve function. Two radiologists reviewed VIBE with pre- and postcontrast subtraction using the 4-point scale. We evaluated the diagnostic performance and compared the degree of therapeutic effect and enhancement of facial nerves that were divided into 5 segments bilaterally. Results We identified 98 facial palsy initially and significant enhancement in 55 facial nerves after the start of therapy and residual palsy in 87. Sensitivity for all facial palsy was 62.0 %, specificity was 90.9 %, positive predictive value was 98.2 %, negative predictive value was 23.3 %, and accuracy was 65.3 %. Eleven patients recovered completely, 1 showed significant enhancement, and the remaining 10 did not show significant enhancement of the facial nerve. Conclusion VIBE has a potential to predict the prognostic outcome and assess facial palsy after the start of therapy. Key points:  Citation Format

Publisher

Georg Thieme Verlag KG

Subject

Radiology, Nuclear Medicine and imaging

Reference21 articles.

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3. Usefulness of contrast-enhanced 3-dimensional T1-VISTA in the diagnosis of facial neuritis: comparison with contrast-enhanced T1-TSE;S J Yun;J Neuroradiol, Elsevier Masson SAS,2015

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