Evaluation of schwannoma using the 3D-SPACE sequence: comparison with the 3D-CISS sequence in 3T-MRI

The purpose of this study is to compare the diagnostic accuracy and interobserver reliability of the T2-weighted 3D-SPACE (three-dimensional sampling perfection with application-optimized contrasts by using different flip angle evolutions) sequence in comparison with T2-weighted 3D-CISS (three-dimensional constructive interference in steady state) sequences for diagnosis of schwannomas.

Forty patients with cerebellopontine angle (CPA), internal acoustic canal (IAC), and cochlear schwannoma who had undergone magnetic resonance imaging (MRI) using the 3D-CISS and 3D-SPACE sequences were identified. The sequences were retrospectively evaluated by two radiologists for the qualitative analyses, which were subsequently compared using the Mann–Whitney U test. Following this, kappa values were used for interobserver agreement. P < 0.05 was considered to be of statistical significance.

The interobserver agreement was found to be excellent between the two observers for the interpretation of all qualitative analyses for both sequences (kappa value > 0.8). The 3D-SPACE sequences demonstrated significantly better qualitative scores and fewer artifacts compared with the 3D-CISS sequences (p < 0.05).

Our results demonstrate that 3D-SPACE is superior to 3D-CISS in the imaging process of the schwannoma in terms of image quality, description of the relationship between the lesion and cranial nerve, signal differentiation between lesion and cistern, and signal differentiation between the lesion and adjacent brain.