Gadolinium-Enhanced MRI Classification of Sudden Sensorineural Hearing Loss and Its Clinical Correlates.

ImportanceSudden sensorineural hearing loss (SSNHL) has heterogeneous etiologies and prognoses. Early-imaging evaluation may help identify patients at higher risk of poor hearing recovery.ObjectiveTo investigate the relationship between labyrinthine gadolinium-enhanced MRI (Gd-MRI) findings and clinical characteristics in patients with SSNHL and to assess the clinical value of MRI-based subtyping for early evaluation and stratified treatment.DesignRetrospective observational study.SettingSingle tertiary referral center.ParticipantsNinety-six patients with unilateral SSNHL treated between January 2014 and May 2020 were included.Exposure or InterventionAll patients underwent gadolinium-enhanced inner ear MRI. According to imaging features, they were categorized into an MRI-negative group, an endolymphatic hydrops (EH) group, and a labyrinthine signal abnormalities (LSA) group.Main Outcome MeasuresClinical symptoms, audiological data, inner ear subunit involvement, and short-term hearing gain were compared among groups. Independent predictors of hearing improvement were analyzed using multivariate linear regression.ResultsAmong 96 patients, 55 were MRI-negative, 20 were EH, and 21 were LSA. The LSA group had the highest rates of vertigo and tinnitus (100% and 95.2%, respectively;