Accuracy of fast spin echo magnetic resonance imaging in the diagnosis of vestibular schwannoma.
OBJECTIVE
An ideal screening test is noninvasive, inexpensive, and has a high specificity and sensitivity. Auditory brain-stem response testing has been the usual screening test for the diagnosis of vestibular schwannoma, although its accuracy in diagnosing small vestibular schwannomas has caused its effectiveness as a screening test to be questioned. Magnetic resonance imaging (MRI) with gadolinium has a high sensitivity and specificity for the diagnosis of vestibular schwannoma. Its use as a screening test for vestibular schwannoma has been limited due to its high cost. Fast spin echo MRI is a technique that provides T2-weighted images with excellent contrast between fluid and neural structures, and its cost is a fraction of a gadolinium MRI scan. This study compares the accuracy of fast spin echo MRI to gadolinium MRI in the diagnosis of vestibular schwannoma.


METHODS
Twenty-five patients (50 ears) in whom there was a clinical suspicion of vestibular schwannoma were scanned with both modalities. All studies were read independently and scored as positive, negative, or indeterminate.


RESULTS
There were 11 true positives and 39 true negatives. There were no false positives or negatives, resulting in a sensitivity of 100% and a specificity of 100%.


CONCLUSIONS
Fast spin echo MRI appears to be an excellent choice as a screening test for vestibular schwannoma due to its low cost, noninvasiveness, and high sensitivity and specificity.
Marx
S V
SV
Department of Radiology, Virginia Mason Medical Center, Seattle, WA, USA.
Langman
A W
AW
Crane
R C
RC
D003390:Cranial Nerve Neoplasms / Q000473:pathology*; D019719:Diagnostic Equipment / Q000592:standards*; D005260:Female; D005682:Gadolinium; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009442:Neurilemmoma / Q000473:pathology*; D011856:Radiographic Image Enhancement; D019275:Radiopharmaceuticals; D014725:Vestibular Nerve / Q000473:pathology*
D019275:Radiopharmaceuticals; D005682:Gadolinium