Comparison of contrast-enhanced T1-weighted and 3D constructive interference in steady state images for predicting outcome after hearing-preservation surgery for vestibular schwannoma

Neuroradiology. 2003 Jul;45(7):476-81. doi: 10.1007/s00234-003-1006-0. Epub 2003 Jun 11.


We compared contrast-enhanced T1-weighted and 3D constructive interference in steady state (CISS) sequences for demonstrating possible prognostic factors in hearing-preservation surgery for vestibular schwannoma. We studied 22 patients with vestibular schwannomas having hearing-preservation surgery. Postoperatively six (27%) had a facial palsy and eight (36%) had hearing loss. There was a significant correlation between the size of the tumour and facial palsy (r=-0.72). Both techniques adequately demonstrated all tumours. Involvement of the fundus of the internal auditory canal (IAC) and a small distance between the lateral border of the tumour and the fundus were correlated significantly with hearing loss (r=-0.81 and -0.75, respectively). The 3D-CISS sequence, by virtue of its high contrast resolution was superior to T1-weighted images ( P<0.05) for detection of the fundal involvement. The direction of displacement of the facial nerve did not correlate with facial palsy or hearing loss. We think that 3D-CISS images better show the features influencing surgical outcome, but that contrast-enhanced T1-weighted images are required for diagnosis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Contrast Media
  • Ear, Inner / pathology
  • Facial Nerve / pathology
  • Facial Nerve Injuries / prevention & control
  • Female
  • Gadolinium DTPA
  • Hearing Disorders / diagnosis*
  • Humans
  • Imaging, Three-Dimensional*
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neuroma, Acoustic / pathology
  • Neuroma, Acoustic / surgery*
  • Otologic Surgical Procedures / methods*
  • Postoperative Complications
  • Postoperative Period
  • Predictive Value of Tests
  • Prospective Studies
  • Weights and Measures


  • Contrast Media
  • Gadolinium DTPA