PT  - JOURNAL ARTICLE
AU  - J L Weissman
AU  - B E Hirsch
AU  - M B Fukui
AU  - T E Rudy
TI  - The evolving MR appearance of structures in the internal auditory canal after removal of an acoustic neuroma.
DP  - 1997 Feb 01
TA  - American Journal of Neuroradiology
PG  - 313--323
VI  - 18
IP  - 2
4099  - http://www.ajnr.org/content/18/2/313.short
4100  - http://www.ajnr.org/content/18/2/313.full
SO  - Am. J. Neuroradiol.1997 Feb 01; 18
AB  - PURPOSE To identify patterns of enhancement in the internal auditory canal (IAC) on MR studies after removal of an acoustic neuroma, including changes in those patterns with time; to evaluate signal and enhancement of the labyrinth; to differentiate normal postoperative findings from those suggesting residual tumor; and to describe MR hallmarks of surgical approaches.METHODS We reviewed the postoperative MR studies obtained in 36 patients who had had surgery for acoustic neuroma (101 images total). Four patterns of IAC enhancement were evaluated, as was labyrinthine signal intensity before and after contrast administration, changes in findings over time, and anatomic alterations caused by surgery.RESULTS All patients had enhancement of the IAC on the first postoperative study. In 30 patients, IAC enhancement remained the same or decreased over time. Seventeen patients had hyperintense cochlear signal and 15 had cochlear enhancement that decreased with time. Effects of retrosigmoid craniotomy, a translabyrinthine surgical approach, and middle fossa craniotomy were recognizable.CONCLUSION Linear enhancement in the IAC is probably normal after surgery. Nodular and masslike enhancement and any progressive enhancement may require close follow-up to monitor growth of residual tumor. Labyrinthine hyperintensity may reflect blood metabolites. An MR protocol is suggested for following up patients in the years after surgery.