Causes of unilateral sensorineural hearing loss screened by high-resolution fast spin echo magnetic resonance imaging: review of 1,070 consecutive cases

Am J Otol. 2000 Mar;21(2):173-80. doi: 10.1016/s0196-0709(00)80005-8.


Objective: Evaluation of the ability of screening high-resolution, nonenhanced, fast spin echo (FSE) T2-weighted magnetic resonance imaging (MRI) of the internal auditory canal (IAC) and cerebellopontine angle (CPA) to detect nonacoustic schwannoma causes of unilateral sensorineural hearing loss (SNHL). FSE-MRI is equally sensitive in detecting acoustic (vestibular) schwannoma as gadolinium-enhanced MRI, but sensitivity to other causes of hearing loss is unknown.

Study design: Retrospective review of screening FSE-MRI studies.

Setting: Academic otology/neurotology and neuroradiology practices.

Patients: There were 1,070 patients with unilateral SNHL who underwent radiologic screening for retrocochlear pathology.

Results: Normal findings were found in 944 cases. Typical (acoustic) vestibular schwannoma were found in 56 patients. Seventy additional lesions were identified: 27 CPA lesions, 29 inner ear lesions, and 12 intraaxial lesions including 9 infarctions, 1 multiple sclerosis case, 1 mesial temporal lobe sclerosis, and 1 colloid cyst.

Conclusions: High-resolution T2 FSE-MRI of the IAC and CPA is a highly sensitive screening tool for unilateral SNHL, which can detect a variety of lesions in addition to vestibular schwannomas. To our knowledge in 2 years of follow-up in these patients screened for IAC/CPA lesions, no other lesions causing SNHL have been found. High-resolution FSE screening technique, used in conjunction with appropriate clinical prescreening and referral, can provide an equally sensitive method of evaluating unilateral SNHL compared to gadolinium-enhanced T1 MRI while reducing costs and providing distinct advantages in evaluating nonacoustic schwannoma causes of SNHL.

MeSH terms

  • Adult
  • Cerebellopontine Angle / pathology*
  • Cochlea / pathology*
  • Cranial Nerve Neoplasms / complications
  • Cranial Nerve Neoplasms / diagnosis
  • Cranial Nerve Neoplasms / epidemiology
  • Echo-Planar Imaging / methods*
  • Female
  • Hearing Loss, Sensorineural / diagnosis*
  • Hearing Loss, Sensorineural / epidemiology
  • Hearing Loss, Sensorineural / etiology*
  • Humans
  • Male
  • Multiple Sclerosis / complications
  • Neuroma, Acoustic / complications
  • Neuroma, Acoustic / diagnosis
  • Neuroma, Acoustic / epidemiology
  • Retrospective Studies