title: Increased cochlear fluid-attenuated inversion recovery signal in patients with vestibular schwannoma.
abstract: OBJECTIVE
  Elevated protein levels have been reported in perilymph of patients with vestibular schwannoma. Fluid-attenuated inversion recovery (FLAIR) imaging is sensitive to high protein contents in fluids. The purpose of this study was to investigate if in patients with unilateral vestibular schwannoma, cochlear FLAIR signal intensity on the affected side is increased compared with the unaffected side and control subjects.
  
  
  METHODS
  Fifteen patients with unilateral vestibular schwannoma and 25 age-matched control subjects (without a history of hearing loss) were retrospectively evaluated. All patients and controls had routine 5-mm FLAIR and T1- and T2-weighted imaging of the brain. The signal intensity of both cochleae was evaluated by placing a small region of interest on FLAIR images. The signal intensity of the brain stem was also determined by placing a second region of interest. A ratio of cochlear signal intensity to brain stem signal intensity (CIBI ratio) was determined. A t test was used to compare the CIBI ratios.
  
  
  RESULTS
  In patients, the mean CIBI ratio of the affected side was 0.89 +/- 0.18, and that of the unaffected side was 0.57 +/- 0.12. In control subjects, it was 0.51 +/- 0.07. The CIBI ratio of the affected side was significantly higher compared with the unaffected side (P < .001) and compared with control subjects (P < .001).
  
  
  CONCLUSIONS
  Patients with vestibular schwannoma have increased cochlear FLAIR signal intensity on the affected side compared with the unaffected side and healthy subjects.
authors.affiliation: Tufts-New England Medical Center and Tufts University, Boston, MA 02215, USA. rbhadeli@bidmc.harvard.edu
authors.forename: R A
authors.initials: RA
authors.lastname: Bhadelia
authors.forename: K L
authors.initials: KL
authors.lastname: Tedesco
authors.forename: S
authors.initials: S
authors.lastname: Hwang
authors.forename: S H
authors.initials: SH
authors.lastname: Erbay
authors.forename: P H
authors.initials: PH
authors.lastname: Lee
authors.forename: W
authors.initials: W
authors.lastname: Shao
authors.forename: C
authors.initials: C
authors.lastname: Heilman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003051:Cochlea / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000175:diagnosis*; D010498:Perilymph / Q000737:chemistry*; D011506:Proteins / Q000032:analysis
chemical_list: D011506:Proteins