Magnetic resonance imaging of cerebellopontine angle lesions

Yadav, Pratiksha; Jantre, Mansi; Thakkar, Dhaval

doi:10.4103/0975-2870.169917

Cited by 9 publications

(5 citation statements)

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“…In both groups, the lesions were more commonly found in the CPA than in the ICA (schwannomas: 16/23 and metastases: 16/20). Presenting symptoms of CPA/IAC masses are dependent on the size and location 21 . These may present with unilateral sensorineural hearing loss, tinnitus, or vertigo when the lesions are located in IAC 9,21 .…”

Section: Discussionmentioning

confidence: 99%

“… 21 These may present with unilateral sensorineural hearing loss, tinnitus, or vertigo when the lesions are located in IAC. 9 , 21 However, when the tumor involves the CPA, clinical manifestations of brainstem or cerebellar compression as well as obstructive hydrocephalus due to effacement of the fourth ventricle can be seen, 21 which could make the CPA lesions more likely investigated by imaging than the IAC lesions. In the group of metastases, lung cancers, breast cancer, and melanoma were identified as primary cancers in this study.…”

Section: Discussionmentioning

confidence: 99%

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Advanced MRI to differentiate schwannomas and metastases in the cerebellopontine angle/internal auditory canal

Ota

Liao

Zhao

et al. 2022

Journal of Neuroimaging

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Background and Purpose: Differentiating schwannomas and metastases in the cerebellopontine angles (CPA)/internal auditory canals (IAC) can be challenging. This study aimed to assess the role of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) to differentiate schwannomas and metastases in the CPA/IAC. Methods: We retrospectively reviewed 368 patients who were diagnosed with schwannomas or metastases in the CPA/IAC between April 2017 and February 2022 in a single academic center. Forty-three patients had pretreatment DWI and DCE-MRI along with conventional MRI. Normalized mean apparent diffusion coefficient ratio (nADCmean) and DCE-MRI parameters of fractional plasma volume (Vp), flux rate constant (Kep), and forward volume transfer constant were compared along with patients' demographics and conventional imaging features between schwannomas and metastases as appropriate. The diagnostic performances and multivariate logistic regression analysis were performed using the significantly different values. Results: Between 23 schwannomas (15 males; median 48 years) and 20 metastases (9 males; median 61 years), nADCmean (median: 1.69 vs. 1.43; p = .002), Vp (median: 0.05 vs. 0.20; p < .001), and Kep (median: 0.41 vs. 0.81 minute −1 ; p < .001) were significantly different. The diagnostic performances of nADCmean, Vp, and Kep were 0.77, 0.90, and 0.83 area under the curves, with cutoff values of 1.68, 0.12, and 0.53, respectively.Vp was identified as the most significant parameter for the tumor differentiation in the multivariate logistic regression analysis (p < .001).Conclusions: DWI and DCE-MRI can help differentiate CPA/IAC schwannomas and metastases, and Vp is the most significant parameter.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Advanced MRI to differentiate schwannomas and metastases in the cerebellopontine angle/internal auditory canal

Ota

Liao

Zhao

et al. 2022

Journal of Neuroimaging

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“…2 Because of these aspects, CPA tumors present an excellent clinical scenario for learning about the auditory temporal resolution component. [3][4] Significant problems such as facial palsy, cerebrospinal fluid leaking, meningitis, and other cranial nerve deficits might occur following surgery. Death, on the other hand, has become a less common consequence as a result of enhanced imaging techniques that allow for early detection, the use of the microscope, and intraoperative monitoring of the cranial nerves.…”

Section: Introductionmentioning

confidence: 99%

Cerebellopontine Angle (CPA) Tumors Presenting with Trigeminal Neuralgia (TN): A Study from LRH, Peshawar

Azam¹,

Tahir²,

Khaliq³

2022

Pak J Neurol Surg

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Background/Objective: The cerebellopontine angle (CPA) is the most prevalent site for brain tumors, accounting for 10% of all cases. CPA tumors can have a direct or indirect pathogenic impact on the auditory nerve and brain stem. The study aimed to quantify the prevalence of cerebellopontine angle tumors in patients with trigeminal neuralgia. Material and Methods: A cross sections study was conducted and 100 patients were included from the Neurosurgery department of LRH, Peshawar. Magnetic resonance images (MRI) were used to look for CPA tumors. The data on CPA tumors were stratified for age and gender. Suboccipital retromastoid craniectomy was performed. Results: The mean age of the patients was 43 years. 38 patients were male and 62 were female. CPA tumors were seen in three percent of trigeminal neuralgia patients. There existed a significant difference (p < 0.00001) between the presence and absence of CPA tumors. A maximum number of patients (n = 37) were not having CPA tumors from the age group of 51-60 years. An insignificant association was reported for CPA distribution concerning age and gender. Conclusion: According to our findings, 3% of trigeminal neuralgia patients had cerebellopontine angle tumors. We urge more investigation and screening of trigeminal neuralgia patients for CPA tumors based on the findings of this study.

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“…Surgical intervention remains the most definitive means for complete tumor removal for most of these lesions. Radiation therapy has gained popularity to arrest tumor growth with specific tumor types and is also an option for patients who are unwilling or medically unable to undergo surgery [2].…”

Section: Introductionmentioning

confidence: 99%

Cerebellopontine Angle Tumors; Tumor Size and Surgical Outcome

Jawad¹

2017

OAJNN

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Object: Our object is to illustrate the various aspects of clinical presentation and surgical complications with linkage to the tumor size regarding cerebellopontine angle (CPA) tumors. Materials and method:This is a prospective study of 30 patients at the Neurosurgical department / Medical city, with mean age of 36 years with CPA tumors (predominantly acoustic neuroma) that underwent surgical removal using a suboccipital retrosigmoid approach over a 1-year period (2015 / 2016).Results: There was a female preponderance. The most common presentation was vertigo followed by tinnitus. There were two cases (6%) of cerebrospinal fluid leak. Facial nerve function was measured by the House Brackmann (HB) system and function further classified into three categories: excellent (HB I-II), intermediate (HB III-IV), and poor (HB V-VI) outcome following surgery, showing that all cases below 20 mm tumor size have an excellent outcome and (67%) of cases with > 20 mm tumor size shows poor outcome. One death in this study (mortality rate, 3%) was due to respiratory cessation. Conclusion:Significant correlation between tumor size and facial nerve outcome, with larger C.P.A. tumors yield worse outcomes. Tumor size also influences the development of CSF leak and operative morbidity and mortality.

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Magnetic resonance imaging of cerebellopontine angle lesions

Cited by 9 publications

References 1 publication

Advanced MRI to differentiate schwannomas and metastases in the cerebellopontine angle/internal auditory canal

Advanced MRI to differentiate schwannomas and metastases in the cerebellopontine angle/internal auditory canal

Cerebellopontine Angle (CPA) Tumors Presenting with Trigeminal Neuralgia (TN): A Study from LRH, Peshawar

Cerebellopontine Angle Tumors; Tumor Size and Surgical Outcome

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