scholarly journals MRI T2-Weighted Cochlear Intensity as a Predictor of Hearing Loss with Vestibular Schwannoma Patients

2021 ◽  
Author(s):  
Peter Q. Luong ◽  
Claudia I. Cabrera ◽  
Nirav Patil ◽  
Hammad Khan ◽  
Carlito Lagman ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Final Analysis ◽  
Hearing Preservation ◽  
Optimal Time ◽  
Resonance Imaging ◽  
Relative Signal Intensity ◽  
Academic Center ◽  
Weighted Magnetic Resonance Imaging ◽  
The Relationship

Abstract Objective It is difficult to predict how hearing loss will progress with vestibular schwannomas (VSs) and to determine the optimal time for hearing preservation interventions. This study investigated the relationship between cochlear intensity on T2-weighted magnetic resonance imaging and hearing loss in VS patients over time. Design Retrospective cohort study. Setting Single major academic center. Participants Patients with a diagnosis of VS from 2007 to 2018. Main Outcome Measures Pure tone average (PTA) and cochlear-to-pontine relative signal intensity (RSI) measured at two time points. Results Fifty patients were included in the final analysis. For both affected and unaffected ears, the trend in PTA increased from baseline to follow-up. For affected ears, the trend in RSI increased from baseline to follow-up, while for the unaffected ears RSI decreased. There was a significant positive correlation between the initial RSI value in the ipsilateral ear when compared with the change in PTA from baseline to follow-up (r = 0.28, p = 0.048). Conclusion There is a trend between initial RSI and how hearing changes in the affected ears of patients with VS. Additional studies are needed to explore how this relationship may be better used to predict hearing loss.

scholarly journals Significance of SCIWORA in adults

2015 ◽  
Vol 14 (2) ◽  
pp. 134-137
Author(s):  
Pedro Luis Bazán
Keyword(s):  
Japanese Orthopaedic Association ◽  
Prospective Evaluation ◽  
Resonance Imaging ◽  
Adult Age ◽  
Intramedullary Lesion ◽  
Central Cord Syndrome ◽  
Asia Score ◽  
The Relationship ◽  
Cervical Arthrosis

<sec><title>OBJECTIVE:</title><p> Recognizing the importance of SCIWORA in adult age; analyze the usefulness of complementary studies; evaluating therapeutic options; learn about the evolution of the treated patients.</p></sec><sec><title>METHODS:</title><p> A prospective evaluation with a minimum follow-up of 5 years, eight elderly patients with cervical arthrosis and diagnosis of SCIWORA. The Japanese Orthopaedic Association (JOA) scale and ASIA were used on admission and at 6, 12, 24, 36, 48 and 60 months.</p></sec><sec><title>RESULTS:</title><p> The central cord syndrome (CCS) was the neurological condition at admission. One patient recovered after corticosteroid therapy, but later, his disability worsened, and he was operated at 18 months, another patient recovered and a third died. The other patients underwent laminoplasty in the first 72 hours; patients with partial severity condition had a minimum improvement of five points in JAO scale and those with severe conditions died.</p></sec><sec><title>CONCLUSIONS:</title><p> The low-energy trauma can decompensate the relationship between container and content in the spine with asymptomatic arthrosis, and can be devastating to the patient. The diagnosis of intramedullary lesion is made by magnetic resonance imaging. Patients with incomplete deficit undergoing laminoplasty reached at least one level in ASIA score. The potential postoperative complications can be serious.</p></sec>

Nine-year Follow-up for a Study of Diffusion-weighted Magnetic Resonance Imaging in a Prospective Prostate Cancer Active Surveillance Cohort

2016 ◽  
Vol 69 (6) ◽  
pp. 1028-1033 ◽  
Author(s):  
Daniel R. Henderson ◽  
Nandita M. de Souza ◽  
Karen Thomas ◽  
Sophie F. Riches ◽  
Veronica A. Morgan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Active Surveillance ◽  
Resonance Imaging ◽  
Diffusion Weighted ◽  
Weighted Magnetic Resonance Imaging

scholarly journals A midline prepontine cyst: Serial magnetic resonance imaging over 20 years shows very slow growth after its rapid shrinkage

2019 ◽  
Vol 32 (2) ◽  
pp. 98-102 ◽  
Author(s):  
Jun Sugata ◽  
Tessei Ueda ◽  
Natsuko Tanoue ◽  
Kazuho Hirahara ◽  
Kiyohisa Kamimura ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Slow Growth ◽  
Ventral Surface ◽  
Cystic Mass ◽  
Resonance Imaging ◽  
Weighted Magnetic Resonance Imaging ◽  
Rare Report ◽  
Pontomedullary Junction

An otherwise healthy 22-month-old boy suffered high fever, irritability, nausea, dysphagia, dysarthria and right hemiparesis. Magnetic resonance imaging showed a cystic mass, 15 mm in diameter, with surrounding oedema in the base of the lower pons. The symptoms subsided in about 10 days after onset, followed by a rapid decrease of the cyst size to 5 mm. Thereafter, the patient’s psychomotor growth has been normal. Annual follow-up magnetic resonance imaging scans showed very gradual enlargement of the cyst located on the ventral surface of the pontomedullary junction, reaching 16 mm in diameter in 21 years after onset. It was hyperintense on T1-weighted and isointense on T2-weighted magnetic resonance imaging. No haemosiderin deposition or gadolinium enhancement was seen. This is a rare report of a two decade longitudinal follow-up of a midline prepontine cyst showing asymptomatic and very slow growth. The possible nature of the cyst includes neurenteric, dermoid and epidermoid cyst.

Hearing preservation in patients with vestibular schwannoma treated with Gamma Knife surgery

2013 ◽  
Vol 118 (3) ◽  
pp. 571-578 ◽  
Author(s):  
Andrew M. Baschnagel ◽  
Peter Y. Chen ◽  
Dennis Bojrab ◽  
Daniel Pieper ◽  
Jack Kartush ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Gamma Knife ◽  
Vestibular Schwannoma ◽  
Hearing Preservation ◽  
Gamma Knife Surgery ◽  
Speech Discrimination ◽  
Before And After ◽  
Nerve Dysfunction ◽  
Preservation Rate

Object Hearing loss after Gamma Knife surgery (GKS) in patients with vestibular schwannoma has been associated with radiation dose to the cochlea. The purpose of this study was to evaluate serviceable hearing preservation in patients with VS who were treated with GKS and to determine if serviceable hearing loss can be correlated with the dose to the cochlea. Methods Forty patients with vestibular schwannoma with serviceable hearing were treated using GKS with a median marginal dose of 12.5 Gy (range 12.5–13 Gy) to the 50% isodose volume. Audiometry was performed prospectively before and after GKS at 1, 3, and 6 months, and then every 6 months thereafter. Hearing preservation was based on pure tone average (PTA) and speech discrimination (SD). Serviceable hearing was defined as PTA less than 50 dB and SD greater than 50%. Results The median cochlear maximum and mean doses were 6.9 Gy (range 1.6–16 Gy) and 2.7 Gy (range 0.7–5.0 Gy), respectively. With a median audiological follow-up of 35 months (range 6–58 months), the 1-, 2-, and 3-year actuarial rates of maintaining serviceable hearing were 93%, 77%, and 74%, respectively. No patient who received a mean cochlear dose less than 2 Gy experienced serviceable hearing loss (p = 0.035). Patients who received a mean cochlear dose less than 3 Gy had a 2-year hearing preservation rate of 91% compared with 59% in those who received a mean cochlear dose of 3 Gy or greater (p = 0.029). Those who had more than 25% of their cochlea receiving 3 Gy or greater had a higher rate of hearing loss (p = 0.030). There was no statistically significant correlation between serviceable hearing loss and age, tumor size, pre-GKS PTA, pre-GKS SD, pre-GKS Gardner-Robertson class, maximum cochlear dose, or the percentage of cochlear volume receiving 5 Gy. On multivariate analysis there was a trend toward significance for serviceable hearing loss with a mean cochlear dose of 3 Gy or greater (p = 0.074). Local control was 100% at 24 months. No patient developed facial or trigeminal nerve dysfunction. Conclusions With a median mean cochlear dose of 2.7 Gy, the majority of patients with serviceable hearing retained serviceable hearing 3 years after GKS. A mean cochlear dose less than 3 Gy was associated with higher serviceable hearing preservation.

Epithelioid Sarcoma of the Peripheral Nerve: Clinicopathologic Series of Three Cases and Literature Review

2020 ◽  
Author(s):  
Julio A Diaz-Perez ◽  
Smiljana Spasic ◽  
Jaylou M Velez-Torres ◽  
Edward F McCarthy ◽  
Andrew E Rosenberg
Keyword(s):  
Magnetic Resonance Imaging ◽  
Literature Review ◽  
Peripheral Nerve ◽  
Epithelioid Sarcoma ◽  
Emission Tomography ◽  
Wide Resection ◽  
Resonance Imaging ◽  
Positron Emission ◽  
Weighted Magnetic Resonance Imaging

Abstract Objectives Epithelioid sarcoma (ES) rarely arises in the nerve. To increase our understanding of this unusual tumor originating in the nerve, we describe the features of three cases and review the literature. Methods Clinical data, imaging, pathology, treatment, and follow-up are detailed. A systematic literature review was conducted. Results Two patients were male and one female; the median age was 24 years. The patients had neurologic symptoms, and the tumors arose in large nerves and ranged from 2.4 to 5.8 cm. The tumors were avid on positron emission tomography–computed tomography and showed increased signal intensity on T2-weighted magnetic resonance imaging. Centered in the nerve, the tumors grew with an infiltrative pattern and encased the nerve fascicles. All were treated with wide resection, and adjuvant treatment included combinations of chemotherapy and radiation. One recurred, and the limb was amputated. Metastases were documented to lymph nodes, lung, pleura, and skin. One patient died of disease after 54 months. Literature review including our cases showed that tumors stained with pancytokeratin (9/9), EMA (4/4), and CD34 (7/7); there was loss of INI1 in all six cases tested. Conclusions ES rarely arises in the peripheral nerve, and its infiltrative nature often requires morbid surgery. The differential includes a variety of benign and malignant epithelioid neoplasms.

Cost analysis of vestibular schwannoma screening with contrast-enhanced magnetic resonance imaging in patients with asymmetrical hearing loss

2015 ◽  
Vol 130 (1) ◽  
pp. 21-24 ◽  
Author(s):  
P Pan ◽  
J Huang ◽  
C Morioka ◽  
G Hathout ◽  
S M El-Saden
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hearing Loss ◽  
Magnetic Resonance ◽  
Vestibular Schwannoma ◽  
Hearing Preservation ◽  
Resonance Imaging ◽  
Screening Cost ◽  
Contrast Enhanced ◽  
New Diagnosis ◽  
The Cost

AbstractBackground:Vestibular schwannomas are a rare cause of asymmetrical hearing loss, and routine screening with magnetic resonance imaging can be costly. This paper reports results on vestibular schwannoma screening at our institution and compares the cost of screening to a utility of hearing benefit.Method:All screening examinations with magnetic resonance imaging performed for asymmetrical hearing loss between 2006 and 2011 were retrospectively reviewed. The cost per new vestibular schwannoma diagnosis was calculated. The cost per patient for those who benefitted from intervention was estimated based on rates of hearing preservation reported in the literature.Results:Forty-five (4.3 per cent) of 1050 screening examinations with magnetic resonance imaging performed for asymmetrical hearing loss were positive for vestibular schwannoma, and the cost per new diagnosis was $11 436. The estimated screening cost per patient for those who benefitted from surgery or radiation was $147 030, while US federal compensation for unilateral hearing loss was $44 888.Conclusion:Although we achieved a lower screening cost per new diagnosis than reported in the current literature, there remains disparity between the screening cost per benefitted patient and the ‘benefit’ of hearing.

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