Comparison of contrast-enhanced T1-weighted and 3D constructive interference in steady state images for predicting outcome after hearing-preservation surgery for vestibular schwannoma
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Date
2003
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Abstract
We compared contrast-enhanced T1-weighted and 3D constructive interference in steady state (CISS) sequences for demonstrating possible prognostic factors in hearing-preservation surgery for vestibular schwannoma. We studied 22 patients with vestibular schwannomas having hearing-preservation surgery. Postoperatively six (27%) had a facial palsy and eight (36%) had hearing loss. There was a significant correlation between the size of the tumour and facial palsy (r=-0.72). Both techniques adequately demonstrated all tumours. Involvement of the fundus of the internal auditory canal (IAC) and a small distance between the lateral border of the tumour and the fundus were correlated significantly with hearing loss (r=-0.81 and -0.75, respectively). The 3D-CISS sequence, by virtue of its high contrast resolution was superior to T1-weighted images (P < 0.05) for detection of the fundal involvement. The direction of displacement of the facial nerve did not correlate with facial palsy or hearing loss. We think that 3D-CISS images better show the features influencing surgical outcome, but that contrast-enhanced T1-weighted images are required for diagnosis.
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Adult , Contrast Media , Ear, Inner , Facial Nerve , Facial Nerve Injuries , Female , Gadolinium DTPA , Hearing Disorders , Humans , Imaging, Three-Dimensional , Magnetic Resonance Imaging , Male , Middle Aged , Neoplasm Invasiveness , Neuroma, Acoustic , Otologic Surgical Procedures , Postoperative Complications , Postoperative Period , Predictive Value of Tests , Prospective Studies , Weights and Measures , gadodiamide , adult , article , clinical article , contrast enhancement , controlled study , correlation analysis , facial nerve , facial nerve paralysis , female , hearing , hearing loss , human , image quality , intermethod comparison , internal auditory canal , male , neurilemoma , postoperative period , priority journal , prognosis , steady state , surgical technique , three dimensional imaging , treatment outcome , tumor volume , vestibular nerve