Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Strasbourg, 1 Avenue Molière, Strasbourg, France.
Institute of Image-Guided Surgery, IHU Strasbourg, 1 place de l'Hôpital, Strasbourg, France.
Eur Arch Otorhinolaryngol. 2021 Nov;278(11):4235-4241. doi: 10.1007/s00405-020-06530-6. Epub 2021 Jan 3.
The first aim is to describe the epidemiological, clinical, and radiological characteristics of regressive vestibular schwannomas (VS), based on volumetric measurements on MRI to define which regressions are significant. The secondary aim is to look for a correlation between a shrinkage of the tumor and the medical history, and the presence of clinical symptoms.
We first selected all patients presenting with a VS who underwent two or more MRI of the internal auditory canal on the same 3 T MRI machine retrospectively between January 2013 and June 2018. All MRI images were evaluated independently by two radiologists. The volumetric analysis was performed contrast-enhanced 2D spin-echo T1-weighted sequence and expressed in cubic centimeters.
Thirty-five patients presented with a regressive VS on MRI (14%). The annual mean shrinkage rate was 0.08 cm/year. Eighty percent of the patients present both a shrinkage by more than 0.01 cm/year and a decrease of the initial tumor volume by more than 20%. The majority of patients are asymptomatic or presented moderate balance disorders, which remained stable or improved over time. Tinnitus was observed in 47% and was stable or improved in the majority of cases and the mean annual mean hearing loss was by < or = 4 dB/year.
Out of 247 VS, 14% decreased using follow-up (by > or = 2 MRI), and a spontaneous shrinkage greater than 0.01 cm/year and greater than 20% could be considered significant.
本研究旨在通过 MRI 体积测量来描述退行性前庭神经鞘瘤（VS）的流行病学、临床和影像学特征，以确定哪些退行性变化具有统计学意义。次要目的是寻找肿瘤退缩与病史和临床症状之间的相关性。
我们首先回顾性地选择了 2013 年 1 月至 2018 年 6 月间在同一台 3T MRI 机器上接受了两次或两次以上内听道 MRI 检查的所有 VS 患者。所有 MRI 图像均由两名放射科医生独立评估。体积分析采用增强二维自旋回波 T1 加权序列，以立方厘米表示。
35 例患者 MRI 显示退行性 VS（14%）。年平均退缩率为 0.08 cm/年。80%的患者表现为每年退缩超过 0.01 cm/年，且初始肿瘤体积减少超过 20%。大多数患者无症状或表现为中度平衡障碍，这些症状随时间推移而稳定或改善。47%的患者出现耳鸣，且多数情况下稳定或改善，平均年听力损失小于或等于 4dB/年。
在 247 例 VS 中，14%的患者在随访中（通过≥2 次 MRI）出现缩小，且每年退缩超过 0.01 cm/年且超过 20%可被认为具有统计学意义。
