Franca Wagner1, Evelyn Herrmann2, Roland Wiest3, Andreas Raabe4, Corrado Bernasconi5, Marco Caversaccio6, Dominique Vibert7. 1. Department of Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland. Electronic address: franca.wagner@insel.ch. 2. Department of Radiation Oncology, Inselspital, University of Bern, Bern, Switzerland. Electronic address: evelyn.herrmann@insel.ch. 3. Department of Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland. Electronic address: roland.wiest@insel.ch. 4. Department of Neurosurgery, Inselspital, University of Bern, Bern, Switzerland. Electronic address: andreas.raabe@insel.ch. 5. Statistics Division, Inselspital, University of Bern, Bern, Switzerland. Electronic address: corrado.bernasconi@insel.ch. 6. Department of Otorhinolaryngology and Head & Neck Surgery, Inselspital, University of Bern, Bern, Switzerland. Electronic address: marco.caversaccio@insel.ch. 7. Department of Otorhinolaryngology and Head & Neck Surgery, Inselspital, University of Bern, Bern, Switzerland. Electronic address: dominique.vibert@insel.ch.
Abstract
OBJECTIVE: To evaluate signal intensity of the inner ear using 3D-CISS imaging and correlated signal characteristics in patients with vestibular schwannoma to neuro-otological symptoms. METHODS: Sixty patients with unilateral vestibular schwannoma were retrospectively reviewed. All patients had had initial and follow-up magnetic resonance imaging (MRI). Individual treatment strategies consisted of "wait-and-watch", surgical tumour resection, stereotactic radiosurgery or both surgery and stereotactic radiosurgery. For all patients a complete baseline and treatment course neuro-otological examination was re-studied. RESULTS: On initial MRI, 3D-CISS sequence signal loss of the membranous labyrinth was present in 20 patients (33.3%); signal loss of cochlea in 20 (33.3%) and coincident signal loss of sacculus/utriculus in 17 (85%) of them. Sequential analysis of follow-up MRI series demonstrated slightly increased labyrinthine signal degradation, independently of the chosen therapy. Correlation of initial MRI results with initial neuro-otological symptoms showed significance only for cochlear obstruction versus vertigo (p=0.0397) and sacculus/utriculus obstruction versus vertigo (p=0.0336). No other statistically significant relationships were noted. CONCLUSION: 3D-constructive interference into steady state (3D-CISS) is appropriate for observing inner ear signal loss in patients with vestibular schwannoma. However, except for vertigo, no significant correlation was noted between initial neuro-otological symptomatology and signal loss of the inner ear.
OBJECTIVE: To evaluate signal intensity of the inner ear using 3D-CISS imaging and correlated signal characteristics in patients with vestibular schwannoma to neuro-otological symptoms. METHODS: Sixty patients with unilateral vestibular schwannoma were retrospectively reviewed. All patients had had initial and follow-up magnetic resonance imaging (MRI). Individual treatment strategies consisted of "wait-and-watch", surgical tumour resection, stereotactic radiosurgery or both surgery and stereotactic radiosurgery. For all patients a complete baseline and treatment course neuro-otological examination was re-studied. RESULTS: On initial MRI, 3D-CISS sequence signal loss of the membranous labyrinth was present in 20 patients (33.3%); signal loss of cochlea in 20 (33.3%) and coincident signal loss of sacculus/utriculus in 17 (85%) of them. Sequential analysis of follow-up MRI series demonstrated slightly increased labyrinthine signal degradation, independently of the chosen therapy. Correlation of initial MRI results with initial neuro-otological symptoms showed significance only for cochlear obstruction versus vertigo (p=0.0397) and sacculus/utriculus obstruction versus vertigo (p=0.0336). No other statistically significant relationships were noted. CONCLUSION: 3D-constructive interference into steady state (3D-CISS) is appropriate for observing inner ear signal loss in patients with vestibular schwannoma. However, except for vertigo, no significant correlation was noted between initial neuro-otological symptomatology and signal loss of the inner ear.