Sa. Renowden et P. Anslow, THE EFFECTIVE USE OF MAGNETIC-RESONANCE-IMAGING IN THE DIAGNOSIS OF ACOUSTIC NEUROMAS, Clinical Radiology, 48(1), 1993, pp. 25-28
The diagnostic approach to acoustic neuromas is complex but these tumo
urs are infrequent in patients even with a suggestive clinical picture
. Easy access to an efficient, reliable and cost effective investigati
on is desirable. Magnetic resonance imaging is now the imaging modalit
y of choice and this paper shows that it may be used effectively as th
e sole investigation. T2-weighted (T2W) fast spin echo axial images ta
king 1 min 37 s to acquire were compared with T1-weighted (T1W) gadoli
nium-enhanced axial images, taking 5 min 11 s to acquire, in 157 patie
nts. The T2W images were satisfactory alone in 43% of patients and all
owed confident diagnosis of seven of the nine acoustic neuromas. Parti
al volume artefact and CSF flow artefact resulted in equivocal examina
tions in the remaining patients. Using both sequences in every patient
, imaging time was 7 min 41 s and at least 40 patients could be examin
ed in 1 day, thus ensuring efficient patient throughput. We suggest th
at T2W fast spin echo axial images be routinely obtained and that only
when they are equivocal should T1W gadolinium-enhanced axial sequence
s be employed.