Four-Hour Delayed Gadolinium-Enhanced 3D-FLAIR MR Imaging Highlights Intralabyrinthine Micro-Schwannomas

• Published in: Otology & neurotology Vol. 42; no. 10; p. e1444
• Main Authors: Kurata, Natsuko, Kawashima, Yoshiyuki, Ito, Taku, Ooka, Tomoki, Tsutsumi, Takeshi
• Format: Journal Article
• Language: English
• Published: United States 01.12.2021
• Subjects: Contrast Media; Gadolinium; Humans; Imaging, Three-Dimensional - methods; Magnetic Resonance Imaging - methods; Neurilemmoma
• ISSN: 1537-4505
• DOI: 10.1097/mao.0000000000003310

To demonstrate the clinical significance of 4-hour delayed gadolinium-enhanced three-dimensional fluid-attenuated inversion recovery (delayed 3D-FLAIR) in patients with intralabyrinthine schwannoma (ILS). Three patients who were clinically diagnosed with ILS. All patients underwent audiological examinations and magnetic resonance imaging (MRI) scans. The MR-protocol included axial MR cisternography, immediate gadolinium-enhanced T1-weighted sequence, and heavily T2-weighted 3D-FLAIR prior to and 4 hours after the intravenous administration of gadolinium contrast medium. All MR images were visually inspected. In all three patients with ILS, delayed 3D-FLAIR MRI demonstrated a strong signal of cochlear fluid surrounding the tumor, which highlighted a tumor region that lacked signals. Delayed 3D-FLAIR MRI may serve as a novel diagnostic tool for the early detection of intralabyrinthine micro-schwannoma. The findings also shed light on the pathophysiology of ILS.