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False positive MRI in the diagnosis of small intracanalicular vestibular schwannomas

Published online by Cambridge University Press:  29 June 2007

Martin J. Donnelly ,
Anne D. Cass  and
Laurie Ryan
Martin J. Donnelly*
Affiliation:
Department of Otolaryngology, University of Melbourne, Melbourne, Australia.
Anne D. Cass
Affiliation:
Department of OtolaryngologyThe Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
Laurie Ryan
Affiliation:
Department of OtolaryngologyThe Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
*
Mr Martin J. Donnelly, University of Melbourne, Department of Otolaryngology, The Royal Victorian Eye and Ear Hospital, 32 Gisbome Street, East Melbourne, Victoria 3002, Australia.
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Abstract

The current gold standard for diagnosing vestibular schwannomas is MRI with gadolinium-DTPA enhancement. This imaging modality is particularly useful in the detection of small intracanalicular tumours which can be missed by CT scanning. We present a case where MRI with enhancement suggested the presence of a 4 mm intracanalicular vestibular schwannoma. Surgical exploration of the internal auditory canal via a retrosigmoid approach, revealed no tumour, but inflammatory arachnoid matter around the vestibular nerve was found. A review of the audiological test results uncovered some results which did not correlate with the interpretation of the MRI scan. We would therefore caution against immediate surgical intervention in patients where the diagnosis of a small intracanalicular vestibular schwannoma is not totally supported by the audiological findings. In such cases rescanning with gadolinium enhancement after a suitable interval is recommended.

Keywords

Magnetic resonance imagingVestibular schwannoma
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 108 , Issue 11 , November 1994 , pp. 986 - 988
Copyright
Copyright © JLO (1984) Limited 1994

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