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DIAGNOSTIC PERFORMANCEOF MAGNETIC RESONANCE IMAGING IN THE DISCREPANCY DIAGNOSIS OF CEREBELLOPONTINE ANGLE MENINGIOMA AND VESTIBULAR SCHWANNOMAS
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Abstract
Objective: Our study aimed to investigate the imaging characteristic and the usefulness of magnetic resonance imaging (MRI) in differentiation diagnosing cerebellopontine angle meningioma and vestibular schwannomas. Materials and Methods: A total of 72 patients (36 patients with meningioma and 36 with vestibular schwannomas) were enrolled in this retrospective study. All patients were diagnosed using conventional MRI sequences and diffusion-weighted imaging (DWI) and were surgically treated and pathologically diagnosed. We identify imaging features of distinguishing the cerebellopontine angle masses comprise tumor shape and consistency, measurement of maximum tumor diameter, the length of internal auditory canal component and dural tail, and tumor imaging manifestation in conventional MRI sequences and DWI. Statical analysis using Mann–Whitney U test, independent-samples t-test, receiver operating characteristic curve (ROC), and Spearman’s correlation analyses. Results: Meningiomas usually appear as homogenous masses, vividly enhanced on T1W post-contrast sequence with the dural-tail sign. VS typically exhibits as a heterogeneous mass, enhancing intensely and extending into and enlarging the internal auditory meatus. On conventional MRI, schwannomas and meningiomas typically appear hypo- or isointense in T1WI. On T2W, meningiomas manifest as a homogeneous isointense and hyperintense signal neoplasm, while schwannomas usually show heterogeneous hyperintensity due to intratumoral hemorrhage and cystic degeneration. In addition to conventional MRI sequences, meningiomas can show restricted diffusion on DWI, unlike vestibular schwannomas that rarely show restricted diffusion. ROC analysis for maximum tumor diameter, the length of internal auditory canal component, and dural tail reveal that the area under the curve values were 0.72, 0.68, and 0.67, respectively. Conclusion: MRI is the modality of choice for differential diagnosis of cerebellopontine angle meningioma and vestibular schwannomas. Also assisting in preoperative planning and prognosis outcome of patients.
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Keywords
cerebellopontine angle, meningioma, vestibular schwannoma, magnetic resonance imaging, apparent diffusion coefficient
References
2. Chen AF, Samy RN, Gantz BJ. Cerebellopontine angle tumor composed of Schwann and meningeal proliferations. Archives of otolaryngology--head & neck surgery. 2001;127(11):1385-1389.
3. Nakamura M, Roser F, Dormiani M, Matthies C, Vorkapic P, Samii M. Facial and cochlear nerve function after surgery of cerebellopontine angle meningiomas. Neurosurgery. 2005;57(1):77-90; discussion 77-90.
4. Grey PL, Moffat DA, Hardy DG. Surgical results in unusual cerebellopontine angle tumours. Clinical otolaryngology and allied sciences. 1996;21(3): 237-243.
5. Lalwani AK, Jackler RK. Preoperative differentiation between meningioma of the cerebellopontine angle and acoustic neuroma using MRI. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. 1993; 109 (1):88-95.
6. Imhof H, Henk CB, Dirisamer A, Czerny C, Gstöttner W. [CT and MRI characteristics of tumours of the temporal bone and the cerebello-pontine angle]. Der Radiologe. 2003;43(3):219-226.
7. Singh K, Singh MP, Thukral C, Rao K, Singh K, Singh A. Role of magnetic resonance imaging in evaluation of cerebellopontine angle schwannomas. Indian journal of otolaryngology and head and neck surgery: official publication of the Association of Otolaryngologists of India. 2015;67(1):21-27.
8. Er A. Diagnostic Efficacy of Signal Intensity Ratio and Apparent Diffusion Coefficient Measurements in Differentiating Cerebellopontine Angle Meningioma and Schwannoma. Erciyes Medical Journal. 2020;42.
9. Gomez-Brouchet A, Delisle MB, Cognard C, et al. Vestibular schwannomas: correlations between magnetic resonance imaging and histopathologic appearance. Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2001; 22(1): 79-86.