Cochlear fossa enhancement at MR evaluation of vestibular schwannoma: Correlation with success at hearing-perservation surgery

PURPOSE: To describe a sign in magnetic resonance (MR) imaging that could r eflect the state of the cochlear nerve before hearing-preservation surgery in small vestibular schwannomas. MATERIALS AND METHODS: Thirty-one patients with serviceable hearing underwe nt 1.5-T MR imaging before hearing-preservation surgery. The presence of co chlear fossa enhancement on T1-weighted spin-echo images obtained after the administration of contrast material was compared with the results of heari ng-preservation surgery. RESULTS: Cochlear fossa enhancement was present in 13 patients, and all of them had total hearing loss after surgery. There was no cochlear fossa enha ncement in 18 patients; 15 maintained serviceable hearing after surgery, an d three had postoperative hearing loss with no serviceable hearing (sensiti vity, 81%; specificity, 100%). CONCLUSION: Cochlear fossa enhancement on T1-weighted spin-echo images seem s to be a reliable sign for analyzing the state of the cochlear nerve. The absence of cochlear fossa enhancement could become an additional criterion for selecting the surgical approach in vestibular schwannomas.