PMID- 29240310
OWN - NLM
STAT- MEDLINE
DCOM- 20190417
LR  - 20190417
IS  - 1749-4486 (Electronic)
IS  - 1749-4478 (Linking)
VI  - 43
IP  - 3
DP  - 2018 Jun
TI  - Diagnostic accuracy of high-resolution T2-weighted MRI vs contrast-enhanced 
      T1-weighted MRI to screen for cerebellopontine angle lesions in symptomatic 
      patients.
PG  - 805-811
LID - 10.1111/coa.13051 [doi]
AB  - OBJECTIVE: To evaluate diagnostic accuracy of high-resolution T2-weighted MRI 
      (T2w) for detecting cerebellopontine angle (CPA) lesions compared to a combined 
      protocol including gadolinium enhanced T1-weighted MRI (GdT1w). SETTING: 
      Department of Radiology & Nuclear Medicine, Radboud University Medical Centre, 
      Nijmegen, The Netherlands. PARTICIPANTS: A random sample of MRIs from 350 
      patients (700 CPAs) with asymmetrical audiovestibular complaints was used, 
      acquired between 2013 and 2016. MAIN OUTCOME MEASURES: Sensitivity, specificity, 
      positive and negative predictive values of T2w results compared to GdT1w and, in 
      patients with any suggestion of CPA pathology, to the complete examination (T1w, 
      GdT1w and T2w). Inter-rater agreement between an experienced neuroradiologist and 
      a less experienced observer was calculated. RESULTS: Results of 678 CPAs in 340 
      patients were analysed. On T2w, the neuroradiologist identified all 27 lesions >2 
      mm in size out of a total of 30 CPA lesions (sensitivity: 90% [95% CI: 
      73.5%-97.9%]). Negative predictive value reached 99.5% (95% CI: 98.7-99.9). One 
      missed lesion of 2 mm would have been detected in clinical practice, as this was 
      one of 14 patients for which additional GdT1w would have been ordered based on 
      T2w alone, increasing sensitivity to 93% (95% CI: 77.9%-99.2%) and negative 
      predictive value to 99.7% (95% CI: 98.9%-100%). Inter-rater agreement for T2w was 
      98% (95% CI: 96.4-98.8). CONCLUSION: T2w has a very high diagnostic accuracy for 
      the presence of CPA lesions in patients with asymmetrical audiovestibular 
      complaints. However, in a screening protocol with T2w only, smallest vestibular 
      schwannomas as well as rare differential diagnoses that probably only would be 
      detected on GdT1w may remain unnoticed.
CI  - (c) 2017 The Authors. Clinical Otolaryngology Published by John Wiley & Sons Ltd.
FAU - Hentschel, M A
AU  - Hentschel MA
AUID- ORCID: 0000-0001-6106-089X
AD  - Department of Otolaryngology, Radboud Institute of Health Sciences, Radboud 
      University Medical Center, Nijmegen, The Netherlands.
FAU - Kunst, H P M
AU  - Kunst HPM
AD  - Department of Otolaryngology, Radboud Institute of Health Sciences, Radboud 
      University Medical Center, Nijmegen, The Netherlands.
FAU - Rovers, M M
AU  - Rovers MM
AD  - Department of Operating Rooms, Radboud Institute of Health Sciences, Radboud 
      University Medical Center, Nijmegen, The Netherlands.
AD  - Department of Health Evidence, Radboud Institute of Health Sciences, Radboud 
      University Medical Center, Nijmegen, The Netherlands.
FAU - Steens, S C A
AU  - Steens SCA
AD  - Department of Radiology and Nuclear Medicine, Radboud University Medical Center, 
      Nijmegen, The Netherlands.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20180108
PL  - England
TA  - Clin Otolaryngol
JT  - Clinical otolaryngology : official journal of ENT-UK ; official journal of 
      Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
JID - 101247023
RN  - 0 (Contrast Media)
SB  - IM
MH  - Adult
MH  - Cerebellar Neoplasms/*diagnostic imaging/pathology
MH  - *Cerebellopontine Angle
MH  - *Contrast Media
MH  - False Negative Reactions
MH  - False Positive Reactions
MH  - Humans
MH  - *Magnetic Resonance Imaging
MH  - Netherlands
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
OTO - NOTNLM
OT  - acoustic
OT  - cerebellopontine angle
OT  - contrast media
OT  - diagnosis
OT  - gadolinium
OT  - hearing loss
OT  - magnetic resonance imaging
OT  - neuroma
EDAT- 2017/12/15 06:00
MHDA- 2019/04/18 06:00
CRDT- 2017/12/15 06:00
PHST- 2017/12/07 00:00 [accepted]
PHST- 2017/12/15 06:00 [pubmed]
PHST- 2019/04/18 06:00 [medline]
PHST- 2017/12/15 06:00 [entrez]
AID - 10.1111/coa.13051 [doi]
PST - ppublish
SO  - Clin Otolaryngol. 2018 Jun;43(3):805-811. doi: 10.1111/coa.13051. Epub 2018 Jan 
      8.