Department of Radiological Technology, School of Health Sciences, Faculty of Medicine, Niigata University, 2-746 Asahimachi-dori, Chuo-ku, Niigata 951-8518, Japan.
Neuroradiology. 2013 Feb;55(3):261-70. doi: 10.1007/s00234-012-1100-2. Epub 2012 Oct 16.
With reported characteristic MR features, it is difficult to differentiate vestibular schwannomas (VSs) from cerebellopontine angle (CPA) meningiomas (CPAMs) in some cases. This study aimed to evaluate vestibular signal intensity changes in patients with VS and those with CPAM on three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA), and to test the effectiveness of the signal intensity change to differentiate these two common CPA tumors.
We retrospectively reviewed 21 patients with unilateral VS, six patients with unilateral CPAM, and 25 control subjects. Setting regions of interest in the bilateral vestibules and cerebellar white matter on 3D-FIESTA, we compared the ratio of the signal intensity (SIR) of the vestibule to that of the cerebellar white matter (SIRv) among the VS, CPAM, and control subject groups. We also compared the ratio of SIRv on the affected side (a-SIRv) to that on the unaffected side (AURv) between the VS and CPAM.
The a-SIRv in the VS group was significantly lower than the overall SIRv in the control subjects (pre-contrast, P < 0.001; post-contrast, P < 0.001) and the a-SIRv in the CPAM group (pre-contrast, P = 0.001; post-contrast, P = 0.001). The AURv in the VS group was significantly lower than that in the CPAM groups (pre-contrast, P < 0.001; post-contrast, P < 0.001).
Decreased vestibular signal intensity on the affected side on 3D-FIESTA was observed in patients with VS, but not in those with CPAM or in normal subjects. The signal intensity change has the potential to be used in differentiating VS from CPAM.
具有报道的典型磁共振成像（MRI）特征，在某些情况下，前庭神经鞘瘤（VSs）与桥小脑角（CPA）脑膜瘤（CPAMs）很难区分。本研究旨在评估 3D-FIESTA 上双侧前庭信号强度变化在 VS 患者和 CPAM 患者中的差异，并测试信号强度变化区分这两种常见 CPA 肿瘤的有效性。
我们回顾性分析了 21 例单侧 VS 患者、6 例单侧 CPAM 患者和 25 例对照组。在 3D-FIESTA 上双侧前庭和小脑白质设置感兴趣区，我们比较了 VS、CPAM 和对照组三组之间的前庭信号强度（SIR）与小脑白质信号强度（SIRv）的比值。我们还比较了 VS 和 CPAM 组患侧（a-SIRv）与健侧（AURv）的比值。
VS 组的 a-SIRv 明显低于对照组（未增强，P < 0.001；增强后，P < 0.001）和 CPAM 组的总体 SIRv（未增强，P = 0.001；增强后，P = 0.001）。VS 组的 AURv 明显低于 CPAM 组（未增强，P < 0.001；增强后，P < 0.001）。
3D-FIESTA 上患侧前庭信号强度降低仅见于 VS 患者，而 CPAM 患者和正常对照组均无此表现。信号强度变化可能有助于区分 VS 和 CPAM。
