MRI screening for acoustic neuroma without gadolinium: value of 3DFT-CISS sequence

To evaluate the efficacy of a gradient-echo sequence (3DFT-CISS) in the diagnosis of acoustic neuromas, two independent observers twice reviewed the images of the temporal bones of 83 patients. Contrast-enhanced T1-weighted spin echo images were used as the reference, showing 18 acoustic neuromas, including 5 purely intracanalicular and one intralabyrinthine tumours. High sensitivity (89-94%), specificity (94-97%) and accuracy (94-95%) were found. Intraobserver (kappa 0.93-1) and interobserver (kappa 0.83-0.84) reproducibility were very good. The smallest intracanalicular tumour was overlooked twice by both observers; the intralabyrinthine tumour once by one observer. All tumours were detected with a less stringent decision criterion, at the expense of lower specificity.