Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-25T09:36:52.639Z Has data issue: false hasContentIssue false
  • English
  • Français

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.
Get access Rights & Permissions [Opens in a new window]

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

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.)

References

Anderson, R. E., Laskoff, J. M. (1990) Ramsay Hunt syndrome mimicking intracanalicular acoustic neuroma on contrast enhanced MR. American Journal of Neuroradiology 11: 409.Google Scholar
Barrs, D. M., Vedder, J. S. (1986) Problems in air cisternography. Archives of Otolaryngology, Head and Neck Surgery 112: 769–772.CrossRefGoogle ScholarPubMed
Bird, C. R., Hasso, A. N., Drayer, B. P., Hinshaw, D. B. Jr, Thompson, J. R. (1985) The cerebellopontine angle and internal auditory canal. Radiology 154: 667–670.Google Scholar
Brackmann, D. E., Kwartler, J. A. (1990) A review of acoustic tumours: 1983–1988. American Journal of Otology 11: 216–232.Google Scholar
Casselman, J. W., Kuhweide, R., Deimling, M., Ampe, W., Dehaene, L., Meeus, L. (1993) Constructive interference in steadystate–3DFT MR imaging of the inner ear and cerebellopontine angle. American Journal of Neuroradiology 14: 47–57.Google Scholar
Curati, W. L., Graif, M., Kingsley, D. P., King, T., Scholtz, C. L., Steiner, R. E. (1986) MRI in acoustic neuroma: a review of 35 patients. Neuroradiology 28: 208–214.CrossRefGoogle ScholarPubMed
Daniels, D. L., Miller, S. J., Meyer, G. A., Pojunas, K. W., Kilgore, D. P., Shaffer, K. A., Williams, A. L., Haughton, V. M. (1987) MR detection of tumour in the internal auditory canal. American Journal of Neuroradiology 8: 249–252.Google Scholar
Enzmann, D. R., O'Donogue, J. (1987) Optimizing MR imaging for detecting small tumours in the cerebellopontine angle and internal auditory canal. American Journal of Neuroradiology 8: 99–106.Google Scholar
Gardner, G., Moretz, W. H., Robertson, J. H., Clark, C.Shea, J. J. Jr (1986) Nonsurgical management of small and intracanalicular acoustic tumour. Otolaryngology-Head and Neck Surgery 94: 328–333.CrossRefGoogle Scholar
Haberman, R. S. II, Kramer, M. B. (1989) False positive MRI and CT findings of an acoustic neuroma. American Journal of Otology 10: 301–303.Google Scholar
Haughton, V. M., Rimm, A. A., Czervionke, L. F., Breger, R. K., Fisher, M. E., Papke, R. A., Hendrix, L. E., Strother, C. M., Turski, P. A., Williams, A. L., Daniels, D. L. (1988) Sensitivity of Gd-DTPA enhanced MR imaging of benign extra-axial tumours. Radiology 166: 829–833.Google Scholar
Hirsch, A., Anderson, H. (1980) Elevated stapedius reflex threshold and pathologic reflex decay: clinical occurrence and significance. Acta Oto-Laryngologica 368 (suppl.): 1–28.Google Scholar
Jackler, R. K., Shapiro, M. S., Dillon, W. P., Pitt, L., Lapser, M. J. (1990) Gadolinium-DTPA enhanced magnetic resonance imaging in acoustic neuroma diagnosis and management. Otolaryngology–Head and Neck Surgery 102: 670–677.CrossRefGoogle ScholarPubMed
Larsson, E. M., Holtas, S. (1986) False diagnosis of acoustic neuroma due to subdural injection during gas CT cisternogram. Journal of Computer Assisted Tomography 10: 1025–1026.Google Scholar
Mikhael, M. A., Wolff, A. P., Sark, I. S., Evanston, I. L. (1987) Current concepts in neuroradiological diagnosis of acoustic neuromas. Laryngoscope 97: 471–476.Google Scholar
Millen, S. J., Daniels, D. L., Meyer, G. A. (1987) Gadoliniumenhanced magnetic resonance imaging in temporal bone lesions. Laryngoscope 99: 257–260.Google Scholar
Robertson, H. J., Hutton, H. P. Jr, Kiting, J. W. (1983) False-positive CT gas cisternogram. American Journal of Neuroradiology 4: 474–477.Google Scholar
Runge, V. M., Shabbily, T. F., Goldstein, H. A., Wood, M. L., Haughton, V. M., Marvel, K. R., Weinstein, M. A., Price, A. C., Heliport, S. M., Kaufman, D. (1988) Gd-DTPA clinical efficacy. Radio graphics 147–179.Google ScholarPubMed
Seltzer, S., Mark, A. S. (1991) Contrast enhancement of the labyrinth on MR scans in patients with sudden hearing loss and vertigo: evidence of labyrinthian disease. American Journal of Neuroradiology 12: 13–16.Google Scholar
Shaffer, K. (1991) MR and CT Imaging of the Head, Neck and Spine. (Latchaw, R. E., ed.), 2nd Edition, Mosby Year Book, Inc., St Louis, pp 927–930.Google Scholar
Stack, J. P., Ramsden, R. T, Anton, N. M., Lye, R. H., Ushered, I., Jenkins, J. P. (1988) Magnetic resonance imaging of acoustic neuromas: the role of gadolinium DTPA. British Journal of Radiology 61: 800–805.CrossRefGoogle ScholarPubMed
Tien, R., Dillon, W. P., Jackler, R. K. (1990) Contrast-enhanced MR imaging of the facial nerve in 11 patients with Bell's palsy. American Journal of Roentgenology 155: 573–579.CrossRefGoogle ScholarPubMed
Vogl, T. H., Bayer, M., Hahn, D., Burning, R., Mets, K., Lissner, J. (1986) Kernspintomographische Untersuchungen be Verdacht if Akustikusneruinom. Fortschritte Auf Dem Gebiette Der Rontgenstrahlen Und Der Nuklearmedizen 145: 611–618.Google Scholar
Von Glass, W.Heidi, C.-T., Cidlinsky, K., Stenglein, C., Christ, P. (1991) False-positive MR imaging in the diagnosis of acoustic neurinomas. Otolaryngology–Head and Neck Surgery 104: 863–866.CrossRefGoogle ScholarPubMed
Wazen, J., Silverstein, H., Narrowly, H., Bessel, B. (1985) Preoperative and postoperative growth rates in acoustic neuromas documented with CT scanning. Otolaryngology–Head and Neck Surgery 93: 151–155.Google Scholar
Wilms, G., Decrop, E., Pelts, C., Demur, P., Marshal, G., Van-Hecke, P., Bert, A. L. (1989) Magnetic resonance imaging in acoustic neuroma. Comparison with CT. Journal Beige de Radiologie 72: 151–158.Google ScholarPubMed
Windle-Taylor, P. C., Dillon, R. S., Canaan, G. S. (1984) acoustic neuroma suspicion index: an aid to investigation and diagnosis. Laryngoscope 94: 1464–1467.CrossRefGoogle ScholarPubMed