Hostname: page-component-848d4c4894-mwx4w Total loading time: 0 Render date: 2024-06-25T02:08:38.246Z Has data issue: false hasContentIssue false
  • English
  • Français

Incidental findings on magnetic resonance imaging of the internal auditory meatus for vestibular schwannoma: a systematic review

Published online by Cambridge University Press:  14 December 2022

P Sooby ,
X Huang  and
G Kontorinis Open the ORCID record for G Kontorinis [Opens in a new window]
P Sooby
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital Campus, Glasgow, UK
X Huang
Affiliation:
Department of Neurology, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
G Kontorinis*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital Campus, Glasgow, UK
*
Corresponding author: Georgios Kontorinis; Email: gkontorinis@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Magnetic resonance imaging of the internal auditory meatus is a highly sensitive and specific way to diagnose vestibular schwannoma. However, the rate of incidental findings with this method is believed to be high and can lead to increased patient anxiety and health interventions with unclear benefit.

Method

A systematic review of the literature was performed using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines to identify incidental findings from magnetic resonance imaging of the internal auditory meatus; 12 studies were identified for inclusion within this review.

Results

A total of 10 666 patients were included within the review. The overall rate of diagnosis of vestibular schwannoma was 0.87 per cent; 21 per cent of the study population had incidental findings on magnetic resonance imaging of the internal auditory meatus, and 9.56 per cent had clinically significant incidental findings.

Conclusion

Standardised pre-scan counselling may mitigate the risks of overdiagnosis, but future work should be undertaken to assess the benefits of such a strategy as well as the exact significance of some incidental findings.

Keywords

Incidental findingsimagingmagnetic resonance imagingvestibular schwannoma
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 11 , November 2023 , pp. 1215 - 1221
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Georgios Kontorinis takes responsibility for the integrity of the content of the paper

References

Wong, H, Amoako-Tuffour, Y, Faiz, K, Shankar, JJS. Diagnostic yield of MRI for sensorineural hearing loss - an audit. Can J Neurol Sci 2020;47:656–60CrossRefGoogle ScholarPubMed
Sajid, IM, Frost, K. Hear me out: rethinking internal auditory meatus magnetic resonance imaging in primary care. A cohort evaluation. J Laryngol Otol 2022;136:37–44CrossRefGoogle ScholarPubMed
Saxby, C, Koumpa, F, Mohamed, S, Singh, A. The use of magnetic resonance imaging in the investigation of patients with unilateral non-pulsatile tinnitus without asymmetrical hearing loss. J Laryngol Otol 2021;135:680–3CrossRefGoogle ScholarPubMed
Yoshimoto, Y. Systematic review of the natural history of vestibular schwannoma. J Neurosurg 2005;103:59–63CrossRefGoogle ScholarPubMed
Ramsden, RT, Moffat, DA. Intracanalicular acoustic neuromas; the case for early surgery. Clin Otolaryngol Allied Sci 1994;19:1–2CrossRefGoogle ScholarPubMed
Zou, J, Hirvonen, T. “Wait and scan” management of patients with vestibular schwannoma and the relevance of non-contrast MRI in the follow-up. J Otol 2017;12:174–84CrossRefGoogle ScholarPubMed
NICE. Recommendations. Hearing loss in adults: assessment and management. In: https://www.nice.org.uk/guidance/ng98/chapter/recommendations [23 May 2023]Google Scholar
Amiraraghi, N, Lim, S, Locke, R, Crowther, JA, Kontorinis, G. Findings on 7000 MRI of the IAM: to scan or not to scan?: A retrospective cohort study. Clin Otolaryngol 2018;43:1607–10CrossRefGoogle ScholarPubMed
Hoekstra, CEL, Prijs, VF, Van Zanten, GA. Diagnostic yield of a routine magnetic resonance imaging in tinnitus and clinical relevance of the anterior inferior cerebellar artery loops. Otol Neurotol 2015;36:359–65CrossRefGoogle ScholarPubMed
Papanikolaou, V, Khan, MH, Keogh, IJ. Incidental findings on MRI scans of patients presenting with audiovestibular symptoms. BMC Ear, Nose Throat Disord 2010;10:6CrossRefGoogle ScholarPubMed
Katzman, GL, Dagher, AP, Patrona, NJ. Incidental findings on brain magnetic resonance imaging from 1,000 asymptomatic volunteers. JAMA 1999;282:36–9CrossRefGoogle Scholar
Vernooij, MW, Ikram, MA, Tanghe, HL, Vincent, AJPE, Hofman, A, Krestin, GP et al. Incidental findings on brain MRI in the general population. N Engl J Med 2007;357:1821–8CrossRefGoogle ScholarPubMed
Yue, NC, Longstreth, WT, Elster, AD, Jungreis, CA, O'Leary, DH, Poirier, VC. Clinically serious abnormalities found incidentally at MR imaging of the brain: data from the Cardiovascular Health Study. Radiology 1997;202:41–6CrossRefGoogle ScholarPubMed
Wardlaw, JM, Davies, H, Booth, TC, Laurie, G, Compston, A, Freeman, C et al. Acting on incidental findings in research imaging. BMJ 2015;351:1–6CrossRefGoogle ScholarPubMed
Page, MJ, McKenzie, JE, Bossuyt, PM, Boutron, I, Hoffmann, TC, Mulrow, CD et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71CrossRefGoogle ScholarPubMed
Ma, LL, Wang, YY, Yang, ZH, Huang, D, Weng, H, Zeng, XT. Methodological quality (risk of bias) assessment tools for primary and secondary medical studies: what are they and which is better? Military Med Res 2020;7:1–11CrossRefGoogle ScholarPubMed
Kalsotra, P, Gupta, R, Gupta, N, Sharma, R, Gupta, S, Gupta, GD. Incidental findings on magnetic resonance imaging in patients with tinnitus. Indian J Otol 2015;21:41Google Scholar
Htun, HM, Mui, SL, Williams, C, Hans, PS. Incidental findings on magnetic resonance imaging of the internal auditory meatus performed to investigate audiovestibular symptoms. J Laryngol Otol 2017;131:32–6CrossRefGoogle ScholarPubMed
Powell, HRF, Choa, DI. Should all patients referred for magnetic resonance imaging scans of their internal auditory meatus be followed up in ENT clinics? Eur Arch Otorhinolaryngol 2010;267:1361–6CrossRefGoogle ScholarPubMed
Mirza, S, Malik, TH, Ahmed, A, Willatt, DJ, Hughes, DG. Incidental findings on magnetic resonance imaging screening for cerebellopontine angle tumours. J Laryngol Otol 2000;114:750–4CrossRefGoogle ScholarPubMed
Ahsan, SF, Standring, R, Osborn, DA, Peterson, E, Seidman, M, Jain, R. Clinical predictors of abnormal magnetic resonance imaging findings in patients with asymmetric sensorineural hearing loss. JAMA Otolaryngol Neck Surg 2015;141:451–6CrossRefGoogle ScholarPubMed
Gibson, LM, Paul, L, Chappell, FM, Macleod, M, Whiteley, WN, Salman, RAS et al. Potentially serious incidental findings on brain and body magnetic resonance imaging of apparently asymptomatic adults: systematic review and meta-analysis. BMJ 2018;363:k4577CrossRefGoogle ScholarPubMed
Huang, X, Grimmond, N, Kontorinis, G. An observational study of T2-weighted white matter hyperintensities on magnetic resonance imaging of the internal auditory meatus and brain: ignore or not? J Laryngol Otol 2021;135:964–9CrossRefGoogle ScholarPubMed
Awad, IA, Spetzler, RF, Hodak, JA, Williams, F, Carey, R. Incidental lesions noted on magnetic resonance imaging of the brain: Prevalence and clinical significance in various age groups. Neurosurg 1987;20:222–7CrossRefGoogle ScholarPubMed
Bryan, RN, Manolio, TA, Schertz, LD, Jungreis, C, Poirier, VC, Elster, AD et al. A method for using MR to evaluate the effects of cardiovascular disease on the brain: the cardiovascular health study. ANJR Am J Neuroradiol 1994;15:1625–33Google ScholarPubMed
De Leeuw, F-E, De Groot, JC, Achten, E, Oudkerk, M, Ramos, P, Heijboer, R et al. Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. The Rotterdam Scan Study. J Neurol Neurosurg Psychiatr 2001;70:9–14CrossRefGoogle Scholar
Tarp, B, Fiirgaard, B, Christensen, T, Jensen, JJ, Black, FT. The prevalence and significance of incidental paranasal sinus abnormalities on MRI. Rhinology 2000;38:33–8Google ScholarPubMed
Gupta, MK, Rauniyar, RK, Ahmad, K, Ansari, S, Pant, AR. Incidental mucosal abnormalities of paranasal sinus in patients referred for MRI brain for suspected intracranial pathology in Eastern Nepal. Asian J Med Sci 2014;5:40–4CrossRefGoogle Scholar
Ikubor, JE, Okolugbo, NE, Ogholoh, OD, Kogha, N, Bemigho-Odonmeta, AP. Incidental sinus findings in brain MRI for suspected intracranial disease. Sahel Med J 2021;24:165–71Google Scholar
Mudgil, SP, Wise, SW, Hopper, KD, Kasales, CJ, Mauger, D, Fornadley, JA. Correlation between presumed sinusitis-induced pain and paranasal sinus computed tomographic findings. Ann Allergy Asthma Immunol 2002;88:223–6CrossRefGoogle ScholarPubMed
Chisholm, EJ, Savy, L, Geyer, M, Choa, D. Magnetic resonance imaging scans for vestibulocochlear nerve tumours: what is actually found? J Laryngol Otol 2006;120:1019–22CrossRefGoogle Scholar
Supplementary material: File

Sooby et al. supplementary material

Tables S1-S2

Download Sooby et al. supplementary material(File)
File 35.3 KB