Stuckey S L, Harris A J, Mannolini S M
Department of Medical Imaging, St Vincent's Public Hospital, Fitzroy, Australia.
AJNR Am J Neuroradiol. 1996 Aug;17(7):1219-25.
To compare constructive interference in the steady state (CISS) three-dimensional Fourier transform (3DFT) MR imaging with contrast-enhanced T1-weighted spin-echo MR imaging for accuracy in detecting acoustic schwannoma.
One hundred twenty-five consecutive patients with possible acoustic schwannoma were examined. The accuracy of CISS-3DFT MR imaging in detecting abnormalities of the cerebellopontine angle, the internal auditory canal, and the inner ear was compared with T1-weighted contrast-enhanced spin-echo MR imaging by independent assessment of both image sets by two observers.
The postcontrast T1-weighted MR images revealed 18 cases of unilateral disease of the cerebellopontine angle and/or the internal auditory canal and no case of an abnormal bilateral cerebellopontine angle and/or internal auditory canal. Twelve cases were pathologically proved acoustic schwannomas. One meningioma of the cerebellopontine angle and one metastatic ependymoma to the cerebellopontine angle and the internal auditory canal was encountered. The four remaining cases had a provisional diagnosis of acoustic schwannoma and were scheduled for follow-up imaging and clinical review. Analysis of whether contrast material would have been administered to the appropriate patients (ie, those with disease of the cerebellopontine angle and/or internal auditory canal) according to CISS MR imaging findings revealed a sensitivity of 100% and a specificity of 98% for observer 1 and a sensitivity of 94% and a specificity of 94% for observer 2.
CISS-3DFT MR imaging, in this patient population, provided high sensitivity and specificity in detecting lesions of the cerebellopontine angle and internal auditory canal; however, further experience is required before a definitive statement regarding the suitability of this technique as a screening procedure can be made. When contrast material cannot be administered, CISS MR imaging may be considered an adequate examination for the evaluation of possible acoustic schwannoma.
比较稳态构成性干扰（CISS）三维傅里叶变换（3DFT）磁共振成像（MRI）与对比增强T1加权自旋回波MRI在检测听神经鞘瘤方面的准确性。
对连续125例可能患有听神经鞘瘤的患者进行检查。由两名观察者独立评估两组图像，比较CISS-3DFT MRI在检测桥小脑角、内耳道和内耳异常方面的准确性与T1加权对比增强自旋回波MRI。
对比增强后的T1加权MRI图像显示18例单侧桥小脑角和/或内耳道疾病，无双侧桥小脑角和/或内耳道异常病例。12例经病理证实为听神经鞘瘤。发现1例桥小脑角脑膜瘤和1例转移至桥小脑角和内耳道的室管膜瘤。其余4例初步诊断为听神经鞘瘤，计划进行后续影像学检查和临床复查。根据CISS MRI成像结果分析是否会对合适的患者（即患有桥小脑角和/或内耳道疾病的患者）使用对比剂，观察者1的敏感性为100%，特异性为98%；观察者2的敏感性为94%，特异性为94%。
在该患者群体中，CISS-3DFT MRI在检测桥小脑角和内耳道病变方面具有较高的敏感性和特异性；然而，在就该技术作为筛查程序的适用性做出明确声明之前，还需要更多经验。当无法使用对比剂时，CISS MRI可被视为评估可能的听神经鞘瘤的充分检查。
