Audiologic Evaluation & Radiologic Procedures

Why does imaging matter for audiologists?

1. Referral Judgement: recognizing red flags that warrant MRI referral to rule out retrocochlear pathology

2. Interpreting Reports: imaging findings directly shape audiologic management

3. Multidisciplinary Communication: sharing a common vocabulary with ENT, neurology, and radiology

4. Device Safety: many current cochlear implants are MRI-conditional; some require magnet removal or a protective head wrap before scanning

What Imaging Orientation is this?

Which side is left and right?

Axial / Horizontal

• the image is always taken from the inferior perspective

What Imaging Orientation is this?

Coronal

• the image is always taken from the posterior perspective

What Imaging Orientation is this?

Sagittal

Computed Tomography (CT) - Imaging Measures

• used to look at bones

• takes a bunch of photos, then puts them together

• used to see: bony labyrinth, internal auditory canal (IAC), cerebellopontine angle (CPA)

what imaging measure is this?

CT

Magnetic Resonance Imaging (MRI) - Imaging Measures

• soft tissues light up

• used to see: membranous labyrinth, detailed internal auditory canal (IAC), detailed cerebellopontine angle (CPA), and neural branches

what imaging measure is this?

MRI

What type of imaging is this?

T1-weighted MRI

• CSF appears dark

What type of imaging is this?

T2-weighted MRI

• CSF appears bright

What type of imaging is this?

T1-weighted with Gadolinium (GAD-enhanced T1 MRI)

• has a contrast agent

• vascular structures and breakdown in the blood-brain barrier are brighter

What is the gold standard for imaging?

T1-weighted with Gadolinium (GAD-enhanced T1 MRI)

What imaging measure would you use to find a retrocochlear pathology (e.g. vestibular schwannoma)?

GAD-enhanced T1 MRI (T1-weighted with Gadolinium)