Appropriateness of imaging often depends upon clinical categorization of vertigo into peripheral (vestibular) and central (affecting central vestibular pathways) categories based upon factors such as onset, duration, persistence, aggravating factors, and results of clinical testing [3-7]. In some cases however, this categorization may be difficult on clinical assessment, especially in less subspecialized care [3]. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Hearing Loss and/or Vertigo Given the density of temporal bone and the rather small size of individual structures of interest, such as ossicles, details of temporal bone morphology are only evident on bone windows. Accordingly, intravenous (IV) contrast is not beneficial for evaluation of temporal bone in patients with conductive hearing loss. CT Head There is no evidence to support use of CT head in patients with conductive hearing loss. CTA Head There is no evidence to support use of CT angiography (CTA) in patients with conductive hearing loss. MRI Head and Internal Auditory Canal MRI of the temporal bone is insufficient in delineation of the bony details usually needed for evaluation of patients with conductive hearing loss, and there is no evidence to support its use as a first-line imaging modality in these patients. MRA Head There is no evidence to support use of MR angiography (MRA) for initial evaluation of patients with conductive hearing loss. MR Venography Head There is no evidence to support use of MR venography (MRV) for initial evaluation of patients with conductive hearing loss.
Hearing Loss and or Vertigo. Appropriateness of imaging often depends upon clinical categorization of vertigo into peripheral (vestibular) and central (affecting central vestibular pathways) categories based upon factors such as onset, duration, persistence, aggravating factors, and results of clinical testing [3-7]. In some cases however, this categorization may be difficult on clinical assessment, especially in less subspecialized care [3]. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Hearing Loss and/or Vertigo Given the density of temporal bone and the rather small size of individual structures of interest, such as ossicles, details of temporal bone morphology are only evident on bone windows. Accordingly, intravenous (IV) contrast is not beneficial for evaluation of temporal bone in patients with conductive hearing loss. CT Head There is no evidence to support use of CT head in patients with conductive hearing loss. CTA Head There is no evidence to support use of CT angiography (CTA) in patients with conductive hearing loss. MRI Head and Internal Auditory Canal MRI of the temporal bone is insufficient in delineation of the bony details usually needed for evaluation of patients with conductive hearing loss, and there is no evidence to support its use as a first-line imaging modality in these patients. MRA Head There is no evidence to support use of MR angiography (MRA) for initial evaluation of patients with conductive hearing loss. MR Venography Head There is no evidence to support use of MR venography (MRV) for initial evaluation of patients with conductive hearing loss.