Right-sided vestibular schwannoma

Clinical History:
This is a 46-year-old female who presented with a history of right ear tinnitus and right ear sensorineural hearing loss.

Diagnosis:
Right-sided vestibular schwannoma

MR Technique:
3.0 T scanner (Siemens Verio) using a 15-channel head coil. Image 1: axial T1-weighted image with fat saturation (TR/TE 298/2.5 ms, scan time 3 min 53 sec, slice thickness 3 mm); Image 2: axial T1-weighted image with fat saturation (TR/TE 298/2.5 ms, scan time 3 min 53 sec, slice thickness 3 mm) after administration of 0.1 mmol/kg gadolinium chelate; Image 3: axial T2 turbo spin echo with a matrix of 320 (TR/TE 6000/96 ms, scan time 1 min 12 sec, thickness 4 mm).

Imaging Findings:
An enhancing lesion is seen, with its epicenter at the porus acusticus internus on the right, with some intracanalicular extension. The internal auditory canal on the right is slightly expanded by the extent of the mass (Images 1, 2). There is lower enhancement centrally with the bulk of the lesion (which is extracanalicular), and this region is also of high signal intensity on T2 weighted images (Image 3). This is most consistent with a necrotic region within the neoplastic mass. There is also adjacent mass effect.