MR imaging of acoustic neurinoma

Fifteen cases of acoustic neurinomas were studied by the use of a 0.15 T magnetic resonance (MR) imager. Three of the patients were male, and twelve were female. The patients' ages ranged from 23 to 67 years. The tumors were measured by means of MR images; the maximum was 37.5 mm across, and the minimum, 10 mm. The MR images of the acoustic neurinomas were hypointense on the T1-weighted images except in one case (isointense), while all cases were hyperintense on the T2-weighted images. MRI was much better than contrastenhanced CT for internal auditory canal (IAC) tumors (78 % versus 36 %), especially by means of coronal oblique image on T2-weighted images. In addition, MRI was more useful in demonstrating a VII - VIII neurocomplex on the non-affected side than was CT (57 % versus 10 %), but it did not demonstrate a VII - VIII neurocomplex on the affected side when a 0.15 T MR imager was used. It is very effective to separate the tumor from the tentorium cerebelli when it is necessary to differentiate an acoustic neurinoma from a meningioma at the cerebellopontine angle. A coronal or coronal oblique image offers information for use in separating the tentorium cerebelli. In small IAC tumors, the increased protein content of the cerebro-spinal fluid in an obstructed IAC and the bound-water effect in small collections of fluid may shorten the relaxation times of the trapped intracanalicular fluid, producing difficulty in the ability to diagnosis small tumors. To reveal cystic components, it was found to be effective to use Gd-DTPA or short-TR short-TE spin-echo images. (author)