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  • Title: Diagnostic yield of a routine magnetic resonance imaging in tinnitus and clinical relevance of the anterior inferior cerebellar artery loops.
    Author: Hoekstra CE, Prijs VF, van Zanten GA.
    Journal: Otol Neurotol; 2015 Feb; 36(2):359-65. PubMed ID: 24691509.
    Abstract:
    OBJECTIVE: To assess the diagnostic yield of a routine magnetic resonance imaging (MRI) scan in patients with (unilateral) chronic tinnitus, to define the frequency of incidental findings, and to assess the clinical relevance of potentially found anterior inferior cerebellar artery (AICA) loops. STUDY DESIGN: Retrospective cohort study. SETTINGS: Tertiary Tinnitus Care Group at the University Medical Center Utrecht. PATIENTS: Three hundred twenty-one patients with chronic tinnitus. INTERVENTION: Routine diagnostic magnetic resonance imaging (MRI) and diagnostic auditory brainstem responses (ABR) when an AICA loop was found. MAIN OUTCOME MEASURE: Relationship between abnormalities on MRI and tinnitus. RESULTS: In 138 patients (45%), an abnormality on the MRI scan was described. In only 7 patients (2.2%), the abnormality probably related to the patient's tinnitus. Results were not significantly better in patients with unilateral tinnitus (abnormalities in 3.2%). Incidental findings, not related to the tinnitus, were found in 41% of the patients. In 70 patients (23%), an AICA loop was found in the internal auditory canal. No significant relationships were found between the presence of an AICA loop and the side of the tinnitus, abnormalities on the ABR or complaints specific to nerve compression syndrome. CONCLUSION: A routine MRI is of little or no value in patients with tinnitus with persistent complaints. Anterior inferior cerebellar artery loops are often encountered on an MRI scan but rarely relate to the tinnitus and should thus be considered incidental findings. It is advised to only perform an MRI when on clinical grounds a specific etiology with tinnitus as the symptom seems probable.
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