Olfactory Dysfunction: Correlation of Olfactory Bulb Volume on MRI and Objective Olfactometry

Purpose: To define the role of olfactory bulb volume measurement by magnetic resonance imaging (MRI) for detecting olfactory dysfunction in comparison with objective olfactometry. Materials and Methods: Thirty patients with Suspected olfactory dysfunction (16 women, 14 men; mean age 52 years, range 20-79 years) were examined by MRI and objective olfactometry between January 2006 and January 2009. Olfactory bulb Volumes were measured by two neuroradiologists using 3D MR data sets. The olfactory function was categorized as normosmia, hyposmia, and anosmia on the basis of objective olfactometry. Pearson correlation coefficients were calculated for objective olfactometry and olfactory bulb Volumes on MRI. ROC analysis was performed to determine whether MRI bulb Volumes can serve to predict anosmia or hyposmia. Results: The bulb volumes measured by MRI ranged from 0 to 135.9 mm(3). Based on olfactometry, anosmia was present in 11 patients (total bulb volume of 15.7 +/- 23.3 mm(3)), hyposmia in 9 patients (total bull) Volume of 50.0 +/- 25.5 mm(3)), and normosmia in 10 patients (total bulb volume of 110.7 +/- 21.5 mm(3)). There was good correlation (r>0.9) between objective olfactometry and olfactory bulb volume on MRI. ROC analysis yielded a cut-off value of 32 mm(3) for anosmia, which had a sensitivity of 0.91 and specificity of 0.947. The cut-off value for olfactory dysfunction was 80.7 mm(3) (sensitivity 0.95; specificity of 0.9). Conclusion: The olfactory bulb Volume determined by MRI is a suitable parameter for diagnosing complete or partial loss of the sense of smell.