LETTERS An Important Pitfall in Diagnosing Intracanalicular Vestibular Schwannoma echnical advances in MR imaging enable scanning of milli- in the amount of blood vessels between different subjects may be Tmeter- and submillimeter-thick slices in a relatively short ac- one cause for the different degrees of enhancement observed on quisition time, so sequences such as contrast-enhanced 3D T1 postcontrast MR images (Fig 1A,-C). (eg, MPRAGE) are included in standard MR imaging protocols Therefore, on the basis of our experience, the presence of in many institutions. The MPRAGE sequence is especially impor- enhancement in this region should be always correlated with the tant for the detection of small lesions such as a small intracanalic- CISS sequence to confirm or exclude the presence of a nodular ular vestibular schwannoma (Koos grade I). lesion, which represents the schwannoma (Fig 1F). The members of our interdisciplinary schwannoma board Knowledge of this pitfall is important so that CISS can be have encountered several patients with varying degrees of added if such an incidental finding is present, to reduce the enhancement in the fundus of the internal auditory canal number of false-positive cases and thereby reduce the unneces- (IAC) who were referred to us with suspected
American Journal of Neuroradiology – American Journal of Neuroradiology
Published: Oct 1, 2019
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