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Non-contrast magnetic resonance imaging for monitoring patients with acoustic neuroma

  • M Forgues (a1), R Mehta (a1), D Anderson (a2), C Morel (a2), L Miller (a2), A Sevy (a1), L Son (a2) and M Arriaga (a1)...



To assess the feasibility of non-contrast T2-weighted magnetic resonance imaging as compared to T1-weighted post-contrast magnetic resonance imaging for detecting acoustic neuroma growth.


Adult patients with acoustic neuroma who underwent at least three magnetic resonance imaging scans of the internal auditory canals with and without contrast in the past nine years were identified. T1- and T2-weighted images were reviewed by three neuroradiologists, and tumour size was measured. Accuracy of the measurements on T2-weighted images was defined as a difference of less than or equal to 2 mm from the measurement on T1-weighted images.


A total of 107 magnetic resonance imaging scans of 26 patients were reviewed. Measurements on T2-weighted magnetic resonance imaging scans were 88 per cent accurate. Measurements on T2-weighted images differed from measurements on T1-weighted images by an average of 1.27 mm, or 10.4 per cent of the total size. The specificity of T2-weighted images was 88.2 per cent and the sensitivity was 77.8 per cent.


The T2-weighted sequences are fairly accurate in measuring acoustic neuroma size and identifying growth if one keeps in mind the caveats associated with the tumour characteristics or location.


Corresponding author

Author for correspondence: Dr Moises Arriaga, Department of Otolaryngology, Louisiana State University Health Sciences Center, 533 Bolivar St, Suite 566, New Orleans, LA 70112, USA E-mail: Fax: +1 504 568 4460


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Dr M Arriaga takes responsibility for the integrity of the content of the paper



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1Hoa, M, Drazin, D, Hanna, G, Schwartz, MS, Lekovic, GP. The approach to the patient with incidentally diagnosed vestibular schwannoma. Neurosurg Focus 2012;33:E2
2Rosenberg, SI. Natural history of acoustic neuromas. Laryngoscope 2000;110:497508
3Nikolopoulos, TP, Fortnum, H, O'Donoghue, G, Baguley, D. Acoustic neuroma growth: a systematic review of the evidence. Otol Neurotol 2010;31:478–85
4Marckmann, P, Skov, L, Rossen, K, Dupont, A, Damholt, MB, Heaf, JG et al. Nephrogenic systemic fibrosis: suspected causative role of gadodiamide used for contrast-enhanced magnetic resonance imaging. J Am Soc Nephrol 2006;17:2359–62
5Gathings, RM, Reddy, R, Santa Cruz, D, Brodell, RT. Gadolinium-associated plaques: a new, distinctive clinical entity. JAMA Dermatol 2015;151:316–19
6Fortnum, H, O'Neill, C, Taylor, R, Lenthall, R, Nikolopoulos, T, Lightfoot, G et al. The role of magnetic resonance imaging in the identification of suspected acoustic neuroma: a systematic review of clinical and cost effectiveness and natural history. Health Technol Assess 2009;13:iii–iv, ix–xi, 1154
7Annesley-Williams, DJ, Laitt, RD, Jenkins, JP, Ramsden, RT, Gillespie, JE. Magnetic resonance imaging in the investigation of sensorineural hearing loss: is contrast enhancement still necessary? J Laryngol Otol 2001;115:1421
8Fiirgaard, B, Pedersen, CB, Lundorf, E. The size of acoustic neuromas: CT and MRI. Neuroradiology 1997;39:599601
9Smouha, EE, Yoo, M, Mohr, K, Davis, RP. Conservative management of acoustic neuroma: a meta-analysis and proposed treatment algorithm. Laryngoscope 2005;115:450–4
10Bakkouri, WE, Kania, RE, Guichard, JP, Lot, G, Herman, P, Huy, PT. Conservative management of 386 cases of unilateral vestibular schwannoma: tumor growth and consequences for treatment. J Neurosurg 2009;110:662–9
11Shirato, H, Sakamoto, T, Sawamura, Y, Kagei, K, Isu, T, Kato, T et al. Comparison between observation policy and fractionated stereotactic radiotherapy (SRT) as an initial management for vestibular schwannoma. Int J Radiat Oncol Biol Phys 1999;44:545–50
12Bozorg Grayeli, A, Kalamarides, M, Ferrary, E, Bouccara, D, El Gharem, H, Rey, A et al. Conservative management versus surgery for small vestibular schwannomas. Acta Otolaryngol 2005;125:1063–8
13Walsh, RM, Bath, AP, Bance, ML, Keller, A, Tator, CH, Rutka, JA. The role of conservative management of vestibular schwannomas. Clin Otolaryngol Allied Sci 2000;25:2839
14Lalwani, AK, Jackler, RK. Preoperative differentiation between meningioma of the cerebellopontine angle and acoustic neuroma using MRI. Otolaryngol Head Neck Surg 1993;109:8895
15Allen, RW, Harnsberger, HR, Shelton, C, King, B, Bell, DA, Miller, R et al. Low-cost high-resolution fast spin-echo MR of acoustic schwannoma: an alternative to enhanced conventional spin-echo MR? AJNR Am J Neuroradiol 1996;17:1205–10
16Ben Salem, D, Martin, D, Baudouin, N, Binnert, D, Romanet, P. MRI screening of vestibular schwannomas without gadolinium: usefulness of the turbo gradient spin echo T2-weighted pulse sequence [in French]. J Neuroradiol 2001;28:97102
17Held, P, Fellner, C, Seitz, J, Graf, S, Fellner, F, Strutz, J. The value of T2(*)-weighted MR images for the diagnosis of acoustic neuromas. Eur J Radiol 1999;30:237–44
18Marx, SV, Langman, AW, Crane, RC. Accuracy of fast spin echo magnetic resonance imaging in the diagnosis of vestibular schwannoma. Am J Otolaryngol 1999;20:211–16
19Soulie, D, Cordoliani, YS, Vignaud, J, Cosnard, G. MR imaging of acoustic neuroma with high resolution fast spin echo T2-weighted sequence. Eur J Radiol 1997;24:61–5
20Stuckey, SL, Harris, AJ, Mannolini, SM. Detection of acoustic schwannoma: use of constructive interference in the steady state three-dimensional MR. AJNR Am J Neuroradiol 1996;17:1219–25
21Naganawa, S, Ito, T, Fukatsu, H, Ishigaki, T, Nakashima, T, Ichinose, N et al. MR imaging of the inner ear: comparison of a three-dimensional fast spin-echo sequence with use of a dedicated quadrature-surface coil with a gadolinium-enhanced spoiled gradient-recalled sequence. Radiology 1998;208:679–85
22Schmalbrock, P, Chakeres, DW, Monroe, JW, Saraswat, A, Miles, BA, Welling, DB. Assessment of internal auditory canal tumors: a comparison of contrast-enhanced T1-weighted and steady-state T2-weighted gradient-echo MR imaging. AJNR Am J Neuroradiol 1999;20:1207–13
23Hermans, R, Van der Goten, A, De Foer, B, Baert, AL. MRI screening for acoustic neuroma without gadolinium: value of 3DFT-CISS sequence. Neuroradiology 1997;39:593–8
24Zealley, IA, Cooper, RC, Clifford, KM, Campbell, RS, Potterton, AJ, Zammit-Maempel, I et al. MRI screening for acoustic neuroma: a comparison of fast spin echo and contrast enhanced imaging in 1233 patients. Br J Radiol 2000;73:242–7
25Curtin, HD. Rule out eighth nerve tumor: contrast-enhanced T1-weighted or high-resolution T2-weighted MR? AJNR Am J Neuroradiol 1997;18:1834–8
26Jackler, RK. Cost-effective screening for acoustic neuroma with unenhanced MR: a clinician's perspective. AJNR Am J Neuroradiol 1996;17:1226–8
27Ozgen, B, Oguz, B, Dolgun, A. Diagnostic accuracy of the constructive interference in steady state sequence alone for follow-up imaging of vestibular schwannomas. AJNR Am J Neuroradiol 2009;30:985–91


Non-contrast magnetic resonance imaging for monitoring patients with acoustic neuroma

  • M Forgues (a1), R Mehta (a1), D Anderson (a2), C Morel (a2), L Miller (a2), A Sevy (a1), L Son (a2) and M Arriaga (a1)...


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