Question 4ĭo cystic vestibular schwannomas behave differently than their solid counterparts? Target PopulationĪdults with vestibular schwannomas with cystic components Recommendation Level 3: MRIs should be obtained annually for 5 years, with interval lengthening thereafter with tumor stability. What is the expected growth rate of vestibular schwannomas on MRI, and how often should they be imaged if a “watch and wait” philosophy is pursued? Target PopulationĪdults with suspected vestibular schwannomas by imaging Recommendation Level 3: T2-weighted MRI may be used to augment visualization of the facial nerve course as part of preoperative evaluation. Is there a role for advanced imaging for facial nerve detection preoperatively (eg, CISS/FIESTA or DTI imaging)? Target PopulationĪdults with proven or suspected vestibular schwannomas by imaging Recommendation Level 2: Postoperative evaluation should be performed with post-contrast 3D T1 MPRAGE, with nodular enhancement considered suspicious for recurrence. Level 3: Preoperative surveillance for growth of a vestibular schwannoma should be followed with either contrast-enhanced 3D T1 MPRAGE or high-resolution T2 (including CISS or FIESTA sequences) MR imaging. Level 3: Standard T1, T2, FLAIR, and DWI MR sequences obtained in axial, coronal, and sagittal plane may be used for detection of vestibular schwannomas. Level 3: Imaging used to detect vestibular schwannomas should use high-resolution T2-weighted and contrast-enhanced T1-weighted MRI. What sequences should be obtained on MRI to evaluate vestibular schwannomas before and after surgery? Target PopulationĪdults with vestibular schwannomas Recommendation Initial Preoperative Evaluation VSTR: Vestibular schwannoma tumor remnant SIMCAST: Segment-interleaved motion-compensated acquisition in steady state PRESTO: Principles of echo-shifting with a train of observations MPRAGE: Magnetization prepared rapid acquisition gradient echo AbbreviationsĪAO-HNS: American Academy of Otolaryngology-Head and Neck SurgeryĬISS: Constructive interference in steady stateįIESTA: Fast imaging employing steady-state acquisitionįLAIR: Fluid attenuated inversion recovery No part of this manuscript has been published or submitted for publication elsewhere. Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA Correspondence:īoston, Massachusetts, Acoustic neuroma, advanced imaging, cystic, growth rate, facial nerve, MRI, vestibular schwannoma Carolina Neurosurgery & Spine Associates, Charlotte, North Carolina, USAĦ. Carolinas Medical Center, Charlotte, North Carolina, USAĥ. Department of Radiology (Neuroradiology), Icahn School of Medicine at Mount Sinai, New York, New York, USAĤ. Division of Neuroradiology, Brigham and Women’s Hospital, Boston, Massachusetts, USAģ. Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USAĢ. Delman, MD 3, Jonathan Parish, MD 4, Tyler Atkins, MD 5, Anthony L. Dunn, MD 1, Wenya Linda Bi, MD, PhD 1, Srinivasan Mukundan, MD, PhD 2, Bradley N. Joint Guidelines Committee of the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) Authors: The Role of Imaging in the Diagnosis and Management of Patients with Vestibular Schwannomasĭownload pdf Neurosurgery, 2017 Sponsored by:Ĭongress of Neurological Surgeons (CNS) and the Section on Tumors Endorsed by: Guidelines on the Management of Patients with Vestibular Schwannoma 5.
0 Comments
Leave a Reply. |