Acoustic neuroma MRI

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Gadolinium-enhanced MRI scan is the definitive diagnostic test for acoustic neuroma and can identify tumors as small as 1-2 millimeter in diameter. On brain MRI, acoustic neuroma characterized by hypointense mass on T1-weighted MRI, and hyperintense mass on T2-weighted MRI.

MRI

Gadolinium-enhanced magnetic resonance imaging (MRI) is the preferred diagnostic test for identifying acoustic neuromas and can identify tumors as small as 1-2 millimeter in diameter.^[1]^[2]


MRI component	Features

T1	Slightly hypointense to the adjacent brain (63%) Isointense to the adjacent brain (37%) May contain hypointense cystic areas
T2	Heterogeneously hyperintense to the adjacent brain Cystic areas fluid intensity May have associated peritumoral arachnoid cysts
T1 C+ (Gd)	Contrast enhancement is vivid But heterogeneous in larger tumors

Post-op MRI: Linear enhancement may not indicate tumor. But if there is nodular enhancement, suspect tumor recurrence which will necessitate follow-up MRI).^[3]

MRI showing Intracanalicular acoustic neuroma^[4]

MRI showing Intrameatal vestibular schwannoma^[5]

References

↑ E. P. Lin & B. T. Crane (2017). “The Management and Imaging of Vestibular Schwannomas”. AJNR. American journal of neuroradiology. 38 (11): 2034–2043. doi:10.3174/ajnr.A5213. PMID 28546250. Unknown parameter |month= ignored (help)
↑ D. F. Wilson, R. S. Hodgson, M. F. Gustafson, S. Hogue & L. Mills (1992). “The sensitivity of auditory brainstem response testing in small acoustic neuromas”. The Laryngoscope. 102 (9): 961–964. doi:10.1288/00005537-199209000-00001. PMID 1518359. Unknown parameter |month= ignored (help)
↑ Acoustic Schwannoma. Radiopedia(2015) http://radiopaedia.org/articles/acoustic-schwannoma Accessed on October 2 2015
↑ Image courtesy of Dr Frank Gaillard. Radiopaedia (original file here).[http://radiopaedia.org/licence Creative Commons BY-SA-NC
↑ Image courtesy of Dr. Roberto Schubert Radiopaedia (original file here).[http://radiopaedia.org/licence Creative Commons BY-SA-NC

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[1] E. P. Lin & B. T. Crane (2017). “The Management and Imaging of Vestibular Schwannomas”. AJNR. American journal of neuroradiology. 38 (11): 2034–2043. doi:10.3174/ajnr.A5213. PMID 28546250. Unknown parameter |month= ignored (help)

[2] D. F. Wilson, R. S. Hodgson, M. F. Gustafson, S. Hogue & L. Mills (1992). “The sensitivity of auditory brainstem response testing in small acoustic neuromas”. The Laryngoscope. 102 (9): 961–964. doi:10.1288/00005537-199209000-00001. PMID 1518359. Unknown parameter |month= ignored (help)

[radio-3] Acoustic Schwannoma. Radiopedia(2015) http://radiopaedia.org/articles/acoustic-schwannoma Accessed on October 2 2015

[4] Image courtesy of Dr Frank Gaillard. Radiopaedia (original file here).[http://radiopaedia.org/licence Creative Commons BY-SA-NC

[5] Image courtesy of Dr. Roberto Schubert Radiopaedia (original file here).[http://radiopaedia.org/licence Creative Commons BY-SA-NC

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