Decreased vestibular signal intensity on 3D-FIESTA in vestibular schwannomas differentiating from meningiomas.
BACKGROUND
With reported characteristic MR features, it is difficult to differentiate vestibular schwannomas (VSs) from cerebellopontine angle (CPA) meningiomas (CPAMs) in some cases. This study aimed to evaluate vestibular signal intensity changes in patients with VS and those with CPAM on three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA), and to test the effectiveness of the signal intensity change to differentiate these two common CPA tumors.


METHODS
We retrospectively reviewed 21 patients with unilateral VS, six patients with unilateral CPAM, and 25 control subjects. Setting regions of interest in the bilateral vestibules and cerebellar white matter on 3D-FIESTA, we compared the ratio of the signal intensity (SIR) of the vestibule to that of the cerebellar white matter (SIRv) among the VS, CPAM, and control subject groups. We also compared the ratio of SIRv on the affected side (a-SIRv) to that on the unaffected side (AURv) between the VS and CPAM.


RESULTS
The a-SIRv in the VS group was significantly lower than the overall SIRv in the control subjects (pre-contrast, P < 0.001; post-contrast, P < 0.001) and the a-SIRv in the CPAM group (pre-contrast, P = 0.001; post-contrast, P = 0.001). The AURv in the VS group was significantly lower than that in the CPAM groups (pre-contrast, P < 0.001; post-contrast, P < 0.001).


CONCLUSIONS
Decreased vestibular signal intensity on the affected side on 3D-FIESTA was observed in patients with VS, but not in those with CPAM or in normal subjects. The signal intensity change has the potential to be used in differentiating VS from CPAM.
Department of Radiological Technology, School of Health Sciences, Faculty of Medicine, Niigata University, 2-746 Asahimachi-dori, Chuo-ku, Niigata 951-8518, Japan. ishikazu@clg.niigata-u.ac.jp
Kazuhiro
K
Ishikawa
Jun
J
Haneda
Kouichirou
K
Okamoto
D000328:Adult; D000368:Aged; D000465:Algorithms; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology*; D008579:Meningioma / Q000473:pathology*; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity