title: Screening for cerebellopontine angle tumors: is a CISS sufficient?
abstract: This study attempted to evaluate the reliability of ultra-thin T2-weighted imaging with a constructive interference in steady state (CISS) sequence as a screening method for tumors in the cerebellopontine angle. A retrospective study of 200 CISS examinations was made by five investigators. The examinations were inspected on plain film supported by clinical information. The interobserver agreement in the detection of lesions was analyzed. Fourteen cases (50% of the contrast-enhancing lesions) were rated pathological by all five readers. One case of subarachnoid lymphoma infiltration was overlooked by all five readers. Overall, six pathological lesions (median = 6, range 1-9) were not identified. The interobserver agreement for all pathological lesions was moderate (kappa=0.53; 95% CI, 0.43-0.62). The mean sensitivity was 77.8% (range 72.0-96.3%), and the mean specificity was 97.6% (range 94.8-100%). The median sensitivity for pathological lesions concerning only patients with acute sensorineural hearing loss (n=148, patients with 20 contrast-enhancing cases) was 86.6% (range 80-100%), and median specificity was 95.2% (range 84.4-96.9%) with a moderate interobserver agreement (kappa=0.55; 95% CI, 0.44-0.66). In our opinion the CISS sequence is a valuable addition to the examination of the cerebellopontine angle but lacks sufficient reliability for the detection of tumors of small size or of tumors adjacent to brain parenchyma or the temporal bone.
authors.affiliation: Department of Neuroradiology, University of Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. goebell@uke.uni-hamburg.de
authors.forename: Einar
authors.initials: E
authors.lastname: Goebell
authors.forename: Thorsten
authors.initials: T
authors.lastname: Ries
authors.forename: Thomas
authors.initials: T
authors.lastname: Kucinski
authors.forename: Ullrich
authors.initials: U
authors.lastname: Grzyska
authors.forename: Bernd
authors.initials: B
authors.lastname: Eckert
authors.forename: Jens
authors.initials: J
authors.lastname: Fiehler
authors.forename: Britta
authors.initials: B
authors.lastname: Eickhoff
authors.forename: Jan
authors.initials: J
authors.lastname: Regelsberger
authors.forename: Christoph
authors.initials: C
authors.lastname: Koch
authors.forename: Herrmann
authors.initials: H
authors.lastname: Zeumer
mesh_terms: D002528:Cerebellar Neoplasms / Q000473:pathology*; D002530:Cerebellopontine Angle / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media