Acoustic neuroma CT

CT scan of the head may be diagnostic of acoustic neuroma. Findings on CT scan diagnostic of acoustic neuroma include erosion and widening of the internal acoustic canal.

• CT scan with bone windows can be of prognostic significance as the extent of widening of the internal auditory meatus and the extent of tumor growth anterior and caudal to the internal auditory meatus are predictive of postoperative hearing loss.
• On CT scan, vestibular schwannoma can be seen as an enhancing lesion in the region of the internal auditory canal with variable extension into the cerebellopontine angle.^[1]
• CT may show erosion and widening of the internal acoustic canal.
• Contrast enhancement is present, but can be underwhelming, especially in larger lesions with cystic components.
• Well-performed scanning can demonstrate tumors 1 – 2 mm in diameter. However, even with intravenous contrast enhancement, thin-cut CT scanning can miss tumors as large as 1.5 cm.
• Fine-cut CT scanning of the internal auditory canal with contrast can detect medium-size or large tumors but are not reliable imaging techniques to detect a tumors smaller than 1 – 1.5 cm.

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