EVALUATION OF MAGNETIC RESONANCE IMAGING (MRI) IN DIAGNOSIS OF ACOUSTIC NEUROMA-COMPARATIVE STUDY WITH PLAIN X-RAY AND CTS- KIMIHISA NOMURA, M.D., MAK

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1 EVALUATION OF MAGNETIC RESONANCE IMAGING (MRI) IN DIAGNOSIS OF ACOUSTIC NEUROMA-COMPARATIVE STUDY WITH PLAIN X-RAY AND CTS- KIMIHISA NOMURA, M.D., MAKOTO SAKAI, M.D., ATSUSHI SHINKAWA, M.D. and HIROSATO MIYAKE, M.D. Department of Otolaryngology, Tokai University School of Medicine, Isehara JUNICHI MATSUKAWA, M.D. Department of Otolaryngology, Nihonkokan Hospital, Kawasaki In order to find an approach to earlier and more acurate diagnosis of acoustic neuroma, a comparative evaluation of MRI, plain X-ray (Stenvers'projection), high resolution CT with or without Metrizamide enhancement and air-ct has been made in five clinical cases of acoustic neuroma. A paramagnetic contrast agent, Gadolinium-diethylenetriamine pentaacetic acid (Gd- DTPA), was used to enhance images resolution in two cases of acoustic neuroma. In MRI, the high MRI revealed enlargement of the neurovascular bundle around the VII and VIII cranial nerves compatible with a diagnosis of acoustic neuroma in all 5 cases, and masses within the cerebellopontine angle were also disclosed. In 2 cases the image of equivocal acoustic neuromas was well enhanced, and these lesions were visualized after intravenous administration of Gd-DTPA. In one of the cases the acoustic neuroma was satisfactorily differentiated from the surrounding cystic lesion with the aid of a contrast medium. Magnetic resonance which uses no ionizing radiation seems to be innocuous and offers several advantages over other imaging methods and CT, which may produce an adverse reaction when a contrast medium is used in CT-cisternography. Further advancement of MR technology will offer greater assistance in differential diagnosis of lesions such as acoustic tumors or other cerebellopontine angle tumors.

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7 5) Maslan MJ et al: Magnetic resonance imaging of temporal bone and cerebellopontine angle lesions. Arch Otolaryngol Head Neck Surg 112: , ) Waluch U et al: Magnetic resonance imaging of acoustic neuromas and other temporal bone diseases. Presented at the 84th annual meeting of the American Roentgen Ray Society. Las Vegas, Nev. 7) DeFilippe GJ and Buchheit WA: Magnetic resonance imaging of acoustic neuromas. Neurosurg 16: , ) Barrs DM and Vedder JS: Problems in air cisterno- graphy. Arch Otolaryngol Head Neck Surg 112: 10) Baker JHL: The application of magnetic resonance imaging in otolaryngology. Laryngoscope 96: 19-26, ) Koenig H et al: Temporal bone region: High-resolution MR imaging using surface coils. Radiol 159: , ) Curati WL et al: Acoustic neuromas: Gd-DTPA enhancement in MR imaging. Radiol 158: , ) Daniels DL et al: Magnetic resonance imaging of the internal auditory canal. Radiol 151: , ) New PJ et al: MR imaging of the acoustic nerves and small acoustic neuromas at 0.6T: Prospective study. Am J Radiol 144: , ) House JW et al: Magnetic resonance imaging in acoustic neuroma diagnosis. Ann Otol Rhinol Laryngol 95: 16-20, ,1986.

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