Marx S V, Langman A W, Crane R C
Department of Radiology, Virginia Mason Medical Center, Seattle, WA, USA.
Am J Otolaryngol. 1999 Jul-Aug;20(4):211-6. doi: 10.1016/s0196-0709(99)90002-9.
An ideal screening test is noninvasive, inexpensive, and has a high specificity and sensitivity. Auditory brain-stem response testing has been the usual screening test for the diagnosis of vestibular schwannoma, although its accuracy in diagnosing small vestibular schwannomas has caused its effectiveness as a screening test to be questioned. Magnetic resonance imaging (MRI) with gadolinium has a high sensitivity and specificity for the diagnosis of vestibular schwannoma. Its use as a screening test for vestibular schwannoma has been limited due to its high cost. Fast spin echo MRI is a technique that provides T2-weighted images with excellent contrast between fluid and neural structures, and its cost is a fraction of a gadolinium MRI scan. This study compares the accuracy of fast spin echo MRI to gadolinium MRI in the diagnosis of vestibular schwannoma.
MATERIALS & METHODS: Twenty-five patients (50 ears) in whom there was a clinical suspicion of vestibular schwannoma were scanned with both modalities. All studies were read independently and scored as positive, negative, or indeterminate.
There were 11 true positives and 39 true negatives. There were no false positives or negatives, resulting in a sensitivity of 100% and a specificity of 100%.
Fast spin echo MRI appears to be an excellent choice as a screening test for vestibular schwannoma due to its low cost, noninvasiveness, and high sensitivity and specificity.
理想的筛查测试应是非侵入性的、成本低廉的，且具有高特异性和高敏感性。听觉脑干反应测试一直是诊断前庭神经鞘瘤的常用筛查测试，尽管其在诊断小型前庭神经鞘瘤方面的准确性使其作为筛查测试的有效性受到质疑。钆增强磁共振成像（MRI）对前庭神经鞘瘤的诊断具有高敏感性和特异性。由于其成本高昂，其作为前庭神经鞘瘤筛查测试的应用受到限制。快速自旋回波MRI是一种能提供T2加权图像的技术，在液体和神经结构之间具有出色的对比度，其成本仅为钆增强MRI扫描的一小部分。本研究比较了快速自旋回波MRI与钆增强MRI在诊断前庭神经鞘瘤方面的准确性。
对25例（50耳）临床怀疑患有前庭神经鞘瘤的患者进行了两种方式的扫描。所有研究均由独立人员阅片，并分为阳性、阴性或不确定。
有11例假阳性和39例假阴性。无假阳性或假阴性，敏感性为100%，特异性为100%。
快速自旋回波MRI因其成本低、非侵入性以及高敏感性和特异性，似乎是作为前庭神经鞘瘤筛查测试的绝佳选择。
