Contrast-enhanced CISS MRI of vestibular schwannomas: phantom and clinical studies

Abstract

Purpose: The purpose of this work was to assess the changes of signal intensity on constructive interference in steady state (CISS) 3D Fourier transformation (3DFT) MRI after administration of Gd-DTPA and to evaluate the efficacy of contrast-enhanced CISS-3DFT MRI to depict the seventh and eighth cranial nerves affected by vestibular schwannomas.

Method: All scans were carried out on a 1.5 T MR unit. First, an experimental study was conducted to evaluate the changes in signal intensity of the CISS-3DFT sequence in relation to the concentration of contrast medium. Second, nine consecutive patients with 11 vestibular schwannomas underwent CISS-3DFT imaging before and after contrast agent administration. Signal intensities of the tumors and nerves were measured and compared between the pre- and postcontrast images. Visualization of the facial and cochlear nerves was rated on pre- and postcontrast CISS imaging independently.

Results: On the phantom study, the CISS-3DFT sequence showed a constant increase in signal intensity as the concentration of Gd-DTPA increased. The contrast between the nerves and tumors significantly increased after contrast agent administration (from 0.1 to 9.0 as mean contrast-to-noise ratio). The ability to depict the nerves was also significantly higher for postcontrast CISS-3DFT imaging than for precontrast.

Conclusion: Although the CISS-3DFT sequence offers similar contrast as other heavily T2-weighted sequences, the signal intensity of contrast-enhanced tumors increased on CISS-3DFT imaging. Contrast-enhanced CISS imaging was valuable for evaluating the seventh and eighth cranial nerves affected by vestibular schwannomas.