Objective: Heavily T2-weighted magnetic resonance imaging (MRI) has been reported to be useful for the diagnosis of lesions of the inner ear or its central connections. We evaluated the usefulness of heavily T2-weighted MRI in 18 patients with cerebellopontine angle tumors.
Methods: The lesions were acoustic neuromas in 14 patients and meningiomas in 4 patients. The findings of heavily T2-weighted MRI were compared with those of three-dimensional T1-weighted gradient field echo MRI.
Results: An accurate description of the situation of the tumor in the internal auditory canal (IAC) was possible, because the inner ear was clearly shown on the heavily T2-weighted magnetic resonance images. We could therefore detect the acoustic neuromas located at the fundus of the IAC and the meningiomas growing into the IAC. The residual tumor in the IAC can be shown postoperatively. It was difficult to demonstrate these findings using three-dimensional T1-weighted gradient field echo MRI because of the poor presentation of the petrous bone structures. The lower cranial nerves and the VIIth and VIIIth cranial nerves were more clearly demonstrated by heavily T2-weighted MRI than by three-dimensional T1-weighted gradient field echo MRI. Using heavily T2-weighted MRI, the VIIth and VIIIth cranial nerves of the lesion side were demonstrated in half of the patients with acoustic neuromas smaller than 2.5 cm.
Conclusion: We conclude that heavily T2-weighted MRI is useful to detect the relationship among the tumor, the IAC, the inner ear, and the surrounding cranial nerves.