Welby John P, Baumel Nicholas M, Daher Ghazal S, Kocharyan Armine, Lohse Christine M, Bathla Girish, Carlson Matthew L, Lane John I, Benson John C
From the Department of Radiology (J.P.W., G.B., J.I.L., J.C.B.), Mayo Clinic, Rochester, Minnesota
Mayo Clinic Alix School of Medicine (N.M.B.), Rochester, Minnesota.
AJNR Am J Neuroradiol. 2025 Mar 4;46(3):567-571. doi: 10.3174/ajnr.A8498.
Vestibular schwannomas (VSs) are benign neurogenic tumors commonly associated with progressive unilateral hearing loss, tinnitus, and vestibular symptoms. Growing evidence links signal changes in the VS-adjacent labyrinth with sensorineural hearing loss. This study seeks to quantify the association of labyrinthine signal on postgadolinium 3D-FLAIR imaging correlates with hearing loss and to evaluate potential longitudinal changes over time.
Selected patients were identified from a prospectively maintained VS registry. Mean signal intensity ratios of the bilateral labyrinth and pons were measured on 3D-FLAIR postgadolinium MRI. Correlations with paired audiometric data, including pure tone average (PTA), word recognition score (WRS), and American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) hearing class within 1 year, were evaluated.
One hundred twenty-five studies obtained from 2015 to 2022 among 66 patients undergoing observational management for sporadic VS were analyzed. Increased signal intensity was noted in the VS-affected labyrinth/contralateral labyrinth (mean ratio 1.56, SD 0.58). Increased signal intensity was associated with increased PTA on both labyrinthine (correlation coefficient [CC] 0.20, = .03) and pontine comparisons (CC 0.24, = .006), and with decreased WRS on pontine comparisons (CC -0.18, = .04). Increased signal intensity was significantly associated with nonserviceable AAO-HNS C/D hearing when intensities were compared with the pons ( = .01) but not the contralateral labyrinth ( = .1). Among 44 patients with available follow-up, no statistically significant associations were identified between audiometric data and signal changes over the same interval.
Increased 3D-FLAIR postgadolinium labyrinthine signal is associated with sensorineural hearing loss; however, its relationship with hearing trajectory remains unclear. Overall findings suggest that while postgadolinium 3D-FLAIR techniques are sensitive to inner ear involvement associated with VS, the driving mechanism and their temporal relationships with labyrinthine signal intensity and hearing impairment remain unknown.
前庭神经鞘瘤（VS）是一种常见的良性神经源性肿瘤，通常与进行性单侧听力丧失、耳鸣和前庭症状相关。越来越多的证据表明，VS相邻迷路的信号变化与感音神经性听力损失有关。本研究旨在量化钆增强三维液体衰减反转恢复（3D-FLAIR）成像上迷路信号与听力损失的相关性，并评估其随时间的潜在纵向变化。
从一个前瞻性维护的VS登记处中选择患者。在钆增强3D-FLAIR MRI上测量双侧迷路和脑桥的平均信号强度比。评估与配对听力数据的相关性，包括一年内的纯音平均听阈（PTA）、言语识别得分（WRS）以及美国耳鼻咽喉头颈外科学会（AAO-HNS）听力分级。
分析了2015年至2022年期间66例接受散发性VS观察性治疗的患者的125项研究。受VS影响的迷路/对侧迷路信号强度增加（平均比值1.56，标准差0.58）。在迷路比较（相关系数[CC]0.20，P = 0.03）和脑桥比较（CC 0.24，P = 0.006）中，信号强度增加均与PTA升高相关，在脑桥比较中与WRS降低相关（CC -0.18，P = 0.04）。当与脑桥比较时，信号强度增加与AAO-HNS C/D级不可用听力显著相关（P = 0.01），但与对侧迷路比较时无显著相关性（P = 0.1）。在44例有随访数据的患者中，未发现听力数据与同一时间段内信号变化之间存在统计学显著相关性。
钆增强后3D-FLAIR迷路信号增强与感音神经性听力损失相关；然而，其与听力轨迹的关系仍不清楚。总体研究结果表明，虽然钆增强后3D-FLAIR技术对与VS相关的内耳受累敏感，但其驱动机制及其与迷路信号强度和听力损害的时间关系仍不清楚。
