Perilymphatic Signal Changes in Vestibular Schwannoma: A Potential Biomarker of Progressive Hearing Loss?

OBJECTIVE

Vestibular schwannomas influence the magnetic resonance (MR) signal intensity (SI) in the vestibular cistern and cochlear perilymph. The aim of this study is to evaluate the relationship between perilymphatic signal changes on gradient-echo T2-weighted 3 T MR sequence and the clinical symptoms.

STUDY

DESIGN

Retrospective case-control study.

SETTING

The study was conducted at the Institute of Image-Guided Surgery in Strasbourg, France.

METHODS

Patients with vestibular schwannoma who underwent magnetic resonance imaging at our institution between 2008 and 2016 were retrospectively reviewed. A control group consisted of individuals without past or present otological symptoms. The vestibular schwannomas were divided into three groups, based on the degree of internal auditory canal obstruction. The SI ratios of the vestibular cistern to cerebrospinal fluid (CSF) and cochlea to CSF were compared with clinical data.

RESULTS

We included 172 patients with vestibular schwannoma and 61 controls. Vestibular schwannoma was associated with a significant decrease of the SI ratio of the vestibular cistern to CSF (0.716 ± 0.297 vs 1.06 ± 0.21, P = .004) and cochlea to CSF (0.66 ± 0.199 vs 0.903 ± 0.011, P = .004) compared to controls, with significant negative correlation between both the SI ratios of the vestibular cistern and cochlea to CSF with tumor volume (P < .001). Among all the symptoms studied, the SI ratio of the cistern normalized by CSF was significantly associated with progressive hearing loss (P = .003).

CONCLUSION

Perilymphatic vestibular cistern and cochlear SI changes appear to be a promising noninvasive biomarker for hearing impairment in vestibular schwannoma.