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High resolution T2 MRI in the diagnosis of cerebellopontine angle and internal auditory canal lesions

  • Author Footnotes
    1 Present address: St. Vincent's Hospital, 390 Victoria St, Darlinghurst, NSW 2010, Australia.
    Jonathan T. Maslan
    Correspondence
    Corresponding author at: Department of Otolaryngology, St. Vincent's Hospital, 390 Victoria St, Darlinghurst, NSW 2010, Australia.
    Footnotes
    1 Present address: St. Vincent's Hospital, 390 Victoria St, Darlinghurst, NSW 2010, Australia.
    Affiliations
    Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
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  • Christopher M. Lack
    Affiliations
    Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
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  • Michael Zapadka
    Affiliations
    Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
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  • Author Footnotes
    2 Present address: Scottsdale Medical Imaging, 3501 N. Scottsdale Rd., Ste. 130, Scottsdale, AZ 85251, USA.
    Tyler G. Gasser
    Footnotes
    2 Present address: Scottsdale Medical Imaging, 3501 N. Scottsdale Rd., Ste. 130, Scottsdale, AZ 85251, USA.
    Affiliations
    Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
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  • Eric Oliver
    Affiliations
    Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
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  • Author Footnotes
    1 Present address: St. Vincent's Hospital, 390 Victoria St, Darlinghurst, NSW 2010, Australia.
    2 Present address: Scottsdale Medical Imaging, 3501 N. Scottsdale Rd., Ste. 130, Scottsdale, AZ 85251, USA.

      Highlights

      • T1 with contrast MRI is the current gold standard in diagnosing inner ear lesions
      • High resolution T2 sequences offer exquisite detail of inner ear structures and can aid in the diagnosis of inner lesions
      • When used independently, both T1 and T2 sequences may miss lesions 5 mm or less in size
      • Both sequences together provide the greatest sensitivity, but T2 alone can have a role in lesion surveillance and monitoring

      Abstract

      High resolution T2 magnetic resonance imaging (MRI) can provide exquisite detail of internal auditory canal (IAC) and cerebellopontine angle (CPA) lesions. In this retrospective case series, blinded imaging sequences were delivered to three radiologists and compared with previously archived clinical reads that were non-blinded and incorporated both T1 + C and T2 sequences together. This article demonstrates high sensitivity and specificity for high resolution T2 MRI particularly with lesions >5 mm. This suggests a role for high resolution T2 MRI as an initial screening sequence or as a surveillance sequence.
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