Jw. Casselman et al., MAGNETIC-RESONANCE EXAMINATION OF THE INNER-EAR AND CEREBELLOPONTINE ANGLE IN PATIENTS WITH VERTIGO AND OR ABNORMAL FINDINGS AT VESTIBULAR TESTING/, Acta oto-laryngologica, 1994, pp. 15-27
The inner ears of 167 patients with vertigo and/or abnormal findings a
t vestibular testing were studied using magnetic resonance (MR). Patho
logy potentially explaining vertigo was found in 54 patients, and was
detected in the posterior fossa (28%), the internal auditory canal (28
%) and the membranous labyrinth (44%). The overall percentage of patho
logy and the percentage of pathology found in the membranous labyrinth
was high and was probably influenced by the referral pattern in our h
ospital where high resolution MR of the inner ear (three dimensional F
ourier transformation-constructive interference in steady state sequen
ce; 3DFT-CISS sequence) is available. Unenhanced, and especially gadol
inium (Gd)-enhanced T1-weighted spin-echo images, are needed to detect
most of the pathology inside the internal auditory canal, and some of
the lesions inside the membranous labyrinth. 3DFT-CISS images are the
only images that can show fibrous obliteration of the intralabyrinthi
ne fluid spaces, and are therefore necessary to recognise most of the
intralabyrinthine pathology. Finally, T2-weighted spin-echo images are
best suited to demonstrate cerebellar or brain stem infarction. An ad
ditional MR-angiography sequence (three dimensional Fourier transforma
tion-fast imaging with steady precession; 3DFT-FISP) is used when vasc
ular compression of the cochleovestibular nerve is suspected. MR is th
e method of choice to look for pathology in patients with vertigo, and
allows detection of pathology that remains invisible with other imagi
ng techniques. However, well adapted sequences are needed to detect th
ese lesions.