Our objective is to report 4 cases of incidentally discovered acoustic neur
omas (ANs) and to determine the incidence of asymptomatic ANs. A prospectiv
e study of 161 consecutive patients undergoing gadolinium-enhanced MRI (Gd-
MRI) at a tertiary-care university-affiliate medical center was carried out
from September 1994 to April 1995. The Gd-MRI scans were performed for ten
tative diagnoses other than AN or sensorineural hearing loss. In 161 consec
utive patients examined, no ANs were found incidentally on Gd-MRI scans, Pr
evious studies have suggested that the incidence of occult ANs is as high a
s 1%. On the basis of our results, we suggest that the actual incidence may
be lower. However, our study is limited by its small size and the low inci
dence of ANs in the general population. Also reported are the clinical and
MRI characteristics of 4 patients with incidentally diagnosed ANs.