Acoustic neuroma MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Gadolinium-enhanced MRI scan is diagnostic of Acoutic neuroma. On brain MRI, glioblastoma is characterized by hypointense mass on T1-weighted MRI and hyperintense mass on T2-weighted MRI

MRI

Magnetic resonance imaging (MRI) using Gadolinium as an enhancing contrast material is the preferred diagnostic test for identifying acoustic neuromas. The image formed clearly defines an acoustic neuroma if it is present and this technique can identify tumors measuring only a few millimeters in diameter. Tumors as small as 1-2 mm in diameter can be demonstrated by well performed MRI scanning. Nonenhanced MRI can miss small tumors.

MRI findings of Acoustic neuroma are: T1

• Slightly hypointense cf. adjacent brain (63%)
• Isointense cf. adjacent brain (37%)
• May contain hypointense cystic areas

T2

• Heterogeneously hyperintense cf. to adjacent brain
• Cystic areas fluid intensity
• May have associated peritumoural arachnoid cysts

T1 C+ (Gd)

• Contrast enhancement is vivid
• But heterogeneous in larger tumors

MRI component	Features
T1	Slightly hypointense cf. adjacent brain (63%) Isointense cf. adjacent brain (37%) May contain hypointense cystic areas
T2	Heterogeneously hyperintense cf. to adjacent brain Cystic areas fluid intensity May have associated peritumoural arachnoid cysts
T1 C+ (Gd)	Contrast enhancement is vivid But heterogeneous in larger tumors

Post-up MRI:Linear enhancement may not indicate tumour, but if there is nodular enhancement suspect tumour recurrence (needs follow up MRI).