Magnetic resonance imaging and computed tomography of the internal auditory canal and cerebellopontine angle

Isr J Med Sci. 1992 Mar-Apr;28(3-4):173-82.

Abstract

Computed tomography (CT) and magnetic resonance imaging (MRI) assessment of internal auditory canal lesions focuses on acoustic neurinomas (Schwannomas), a small percentage of which are entirely intracanalicular. MR is now the imaging method of choice and allows for the detection of intracanalicular tumors as small as 3 mm. Acoustic neurinomas are isointense relative to the pons on MR T1-weighted images, mildly hyperintense on MR T2-weighted images, and enhance intensely after i.v. administration of gadolinium-DTPA. The radiologic evaluation of the cerebellopontine angle first addresses lesions of the angle itself, other than acoustic neurinomas. On CT, meningiomas show calcifications in 25% of cases and homogeneous enhancement in 90%; on MR they demonstrate homogeneous gadolinium-DTPA enhancement. Epidermoids do not enhance on MR. Cholesterol granulomas are strongly hyperintense on MR T1- and T2-weighted images. Rare vascular lesions may mimic neoplasm in the posterior fossa and in the cerebellopontine angle: vertebral basilar dolichoectasia, vascular loop or aneurysm of the anterior inferior cerebellar artery. CT and MR characteristics of lesions extending into the cerebellopontine angle cistern are then reviewed: nonacoustic posterior fossa schwannomas, which have the same MR signal characteristics as the acoustic schwannoma; jugular fossa lesions, the most often encountered being the glomus jugular tumor; and rare intraxial posterior fossa tumors that extend into the cerebellopontine angle.

Publication types

  • Review

MeSH terms

  • Cerebellar Neoplasms / diagnosis*
  • Cerebellar Neoplasms / pathology
  • Cerebellopontine Angle* / diagnostic imaging
  • Cerebellopontine Angle* / pathology
  • Cholesterol
  • Contrast Media
  • Cysts / diagnosis
  • Gadolinium DTPA
  • Humans
  • Magnetic Resonance Imaging*
  • Meningeal Neoplasms / diagnosis
  • Meningioma / diagnosis
  • Neuroma, Acoustic / diagnosis*
  • Organometallic Compounds
  • Pentetic Acid
  • Tomography, X-Ray Computed*
  • Vascular Diseases / diagnosis

Substances

  • Contrast Media
  • Organometallic Compounds
  • Pentetic Acid
  • Cholesterol
  • Gadolinium DTPA