3D-constructive interference into steady state (3D-CISS) labyrinth signal alteration in patients with vestibular schwannoma

Auris Nasus Larynx. 2018 Aug;45(4):702-710. doi: 10.1016/j.anl.2017.09.011. Epub 2017 Sep 22.

Abstract

Objective: To evaluate signal intensity of the inner ear using 3D-CISS imaging and correlated signal characteristics in patients with vestibular schwannoma to neuro-otological symptoms.

Methods: Sixty patients with unilateral vestibular schwannoma were retrospectively reviewed. All patients had had initial and follow-up magnetic resonance imaging (MRI). Individual treatment strategies consisted of "wait-and-watch", surgical tumour resection, stereotactic radiosurgery or both surgery and stereotactic radiosurgery. For all patients a complete baseline and treatment course neuro-otological examination was re-studied.

Results: On initial MRI, 3D-CISS sequence signal loss of the membranous labyrinth was present in 20 patients (33.3%); signal loss of cochlea in 20 (33.3%) and coincident signal loss of sacculus/utriculus in 17 (85%) of them. Sequential analysis of follow-up MRI series demonstrated slightly increased labyrinthine signal degradation, independently of the chosen therapy. Correlation of initial MRI results with initial neuro-otological symptoms showed significance only for cochlear obstruction versus vertigo (p=0.0397) and sacculus/utriculus obstruction versus vertigo (p=0.0336). No other statistically significant relationships were noted.

Conclusion: 3D-constructive interference into steady state (3D-CISS) is appropriate for observing inner ear signal loss in patients with vestibular schwannoma. However, except for vertigo, no significant correlation was noted between initial neuro-otological symptomatology and signal loss of the inner ear.

Keywords: 3D-CISS; Labyrinth signal loss; MRI; Treatment; Vertigo; Vestibular schwannoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ear, Inner / diagnostic imaging*
  • Humans
  • Imaging, Three-Dimensional
  • Magnetic Resonance Imaging
  • Middle Aged
  • Neuroma, Acoustic / diagnostic imaging*
  • Neuroma, Acoustic / physiopathology
  • Neuroma, Acoustic / therapy
  • Otorhinolaryngologic Surgical Procedures
  • Radiosurgery
  • Saccule and Utricle / diagnostic imaging*
  • Vertigo / diagnostic imaging*
  • Vertigo / physiopathology
  • Watchful Waiting
  • Young Adult