Assessing MRI interpretability of the orbit, paranasal sinuses, and nasopharynx in cochlear implant patients

ObjectivesDue to a growing focus on cost-effectiveness in healthcare, safety concerns with CI and the known limitations in image quality, there is an increasing need for well-considered indications before performing magnetic resonance imaging (MRI) in CI (cochlear implant) patients. This study aims...

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Main Authors: M. C. Ketterer, P. Arnold, A. Aschendorff, S. Granitzer, M. Reich, A. K. Rauch, T. Hildenbrand, S. Arndt, L. Fries
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1636128/full
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author M. C. Ketterer
P. Arnold
A. Aschendorff
S. Granitzer
M. Reich
A. K. Rauch
T. Hildenbrand
S. Arndt
L. Fries
author_facet M. C. Ketterer
P. Arnold
A. Aschendorff
S. Granitzer
M. Reich
A. K. Rauch
T. Hildenbrand
S. Arndt
L. Fries
author_sort M. C. Ketterer
collection DOAJ
description ObjectivesDue to a growing focus on cost-effectiveness in healthcare, safety concerns with CI and the known limitations in image quality, there is an increasing need for well-considered indications before performing magnetic resonance imaging (MRI) in CI (cochlear implant) patients. This study aims to evaluate, for the first time, the clinical utility and limitations of MRI in CI patients for orbital, paranasal, and nasopharyngeal assessments.Materials and methodsCIs were positioned and fixed with bandaging around the head of a test subject at varying angular positions (90°, 120°, and 135°), both unilaterally and bilaterally, with and without the magnet in place. MRI acquisitions included T1-MP-RAGE, T2-TSE, T1-TIRM, and DWI sequences of a 3 Tesla MRI scanner. The MRI images were reconstructed three-dimensionally, and the resulting artifacts were analyzed to determine the interpretability of the predefined orbital, paranasal, and nasopharyngeal structures.ResultsImage quality was categorized into four levels of restriction. It was observed that orbital MRI diagnostics in the required sequences (T1, T2, and DWI) are feasible even in patients with bilateral CIs with magnets in situ. Regarding the paranasal sinuses, artifacts affected the sphenoid sinus and parts of the ethmoidal cells; however, as expected, the interpretability improved significantly without the magnet. The nasopharyngeal space, particularly in patients with bilateral CIs and magnets in situ, could be evaluated only with difficulty or was largely not assessable.ConclusionThis study offers insights into the predictive factors influencing the interpretability of MRI scans for the orbit, paranasal sinuses, and nasopharynx in CI patients. In particular, for the sphenoid sinus and nasopharynx, it is strongly advised to consult the responsible CI center before undergoing an MRI examination. This consultation helps assess the necessity of the MRI and, if required, consider the removal of the implant magnet.
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spelling doaj-art-0eb335a3b9c64bab8564fcaa1afa1a252025-08-20T03:58:35ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-07-011610.3389/fneur.2025.16361281636128Assessing MRI interpretability of the orbit, paranasal sinuses, and nasopharynx in cochlear implant patientsM. C. Ketterer0P. Arnold1A. Aschendorff2S. Granitzer3M. Reich4A. K. Rauch5T. Hildenbrand6S. Arndt7L. Fries8Department of Otorhinolaryngology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyDepartment of Radiology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyDepartment of Otorhinolaryngology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyOticon Medical, Vallauris, FranceEye Center, Faculty of Medicine, Albert-Ludwigs University Freiburg, Freiburg, GermanyDepartment of Otorhinolaryngology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyDepartment of Otorhinolaryngology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyDepartment of Otorhinolaryngology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyDepartment of Otorhinolaryngology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyObjectivesDue to a growing focus on cost-effectiveness in healthcare, safety concerns with CI and the known limitations in image quality, there is an increasing need for well-considered indications before performing magnetic resonance imaging (MRI) in CI (cochlear implant) patients. This study aims to evaluate, for the first time, the clinical utility and limitations of MRI in CI patients for orbital, paranasal, and nasopharyngeal assessments.Materials and methodsCIs were positioned and fixed with bandaging around the head of a test subject at varying angular positions (90°, 120°, and 135°), both unilaterally and bilaterally, with and without the magnet in place. MRI acquisitions included T1-MP-RAGE, T2-TSE, T1-TIRM, and DWI sequences of a 3 Tesla MRI scanner. The MRI images were reconstructed three-dimensionally, and the resulting artifacts were analyzed to determine the interpretability of the predefined orbital, paranasal, and nasopharyngeal structures.ResultsImage quality was categorized into four levels of restriction. It was observed that orbital MRI diagnostics in the required sequences (T1, T2, and DWI) are feasible even in patients with bilateral CIs with magnets in situ. Regarding the paranasal sinuses, artifacts affected the sphenoid sinus and parts of the ethmoidal cells; however, as expected, the interpretability improved significantly without the magnet. The nasopharyngeal space, particularly in patients with bilateral CIs and magnets in situ, could be evaluated only with difficulty or was largely not assessable.ConclusionThis study offers insights into the predictive factors influencing the interpretability of MRI scans for the orbit, paranasal sinuses, and nasopharynx in CI patients. In particular, for the sphenoid sinus and nasopharynx, it is strongly advised to consult the responsible CI center before undergoing an MRI examination. This consultation helps assess the necessity of the MRI and, if required, consider the removal of the implant magnet.https://www.frontiersin.org/articles/10.3389/fneur.2025.1636128/fullmagnetic resonance imagingartifactcochlear implantorbitalparanasal sinus
spellingShingle M. C. Ketterer
P. Arnold
A. Aschendorff
S. Granitzer
M. Reich
A. K. Rauch
T. Hildenbrand
S. Arndt
L. Fries
Assessing MRI interpretability of the orbit, paranasal sinuses, and nasopharynx in cochlear implant patients
Frontiers in Neurology
magnetic resonance imaging
artifact
cochlear implant
orbital
paranasal sinus
title Assessing MRI interpretability of the orbit, paranasal sinuses, and nasopharynx in cochlear implant patients
title_full Assessing MRI interpretability of the orbit, paranasal sinuses, and nasopharynx in cochlear implant patients
title_fullStr Assessing MRI interpretability of the orbit, paranasal sinuses, and nasopharynx in cochlear implant patients
title_full_unstemmed Assessing MRI interpretability of the orbit, paranasal sinuses, and nasopharynx in cochlear implant patients
title_short Assessing MRI interpretability of the orbit, paranasal sinuses, and nasopharynx in cochlear implant patients
title_sort assessing mri interpretability of the orbit paranasal sinuses and nasopharynx in cochlear implant patients
topic magnetic resonance imaging
artifact
cochlear implant
orbital
paranasal sinus
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1636128/full
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