scholarly journals Magnetic Resonance Cisternography Using the Fast Spin Echo Method for the Evaluation of Vestibular Schwannoma

1999 ◽  
Vol 39 (4) ◽  
pp. 282-287 ◽  
Author(s):  
Shigeru NISHIZAWA ◽  
Tetsuo YOKOYAMA ◽  
Kenichi UEMURA
Keyword(s):  
Magnetic Resonance ◽  
Vestibular Schwannoma ◽  
Spin Echo ◽  
Fast Spin Echo ◽  
Magnetic Resonance Cisternography ◽  
Fast Spin

Ultra high resolution nonenhanced fast spin echo magnetic resonance imaging: Cost-effective screening for acoustic neuroma in patients with sudden sensorineural hearing loss

1998 ◽  
Vol 119 (4) ◽  
pp. 364-369 ◽  
Author(s):  
Robert L. Daniels ◽  
Clough Shelton ◽  
H. Ric Harnsberger
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hearing Loss ◽  
Magnetic Resonance ◽  
Sensorineural Hearing Loss ◽  
Acoustic Neuroma ◽  
Spin Echo ◽  
Sudden Sensorineural Hearing Loss ◽  
Fast Spin Echo ◽  
Resonance Imaging ◽  
Fast Spin

The financial burden for the evaluation of patients for acoustic neuroma in an otolaryngology practice is substantial. Patients with sudden sensorineural hearing loss represent a portion of that population seen with unilateral, asymmetric auditory symptoms who require investigation for acoustic neuroma. For these patients, gadolinium-enhanced magnetic resonance imaging is the diagnostic gold standard. Auditory brain stem response testing has been used in the past as a screening test for acoustic neuroma, but its apparent sensitivity has fallen as the ability to image smaller acoustic neuromas has improved. Fast spin echo magnetic resonance imaging techniques without gadolinium have been shown to be as effective in the detection of acoustic neuroma as contrast-enhanced magnetic resonance imaging. Limited nonenhanced fast spin echo magnetic resonance imaging now provides an inexpensive alternative for high-resolution imaging of the internal auditory canal and cerebellopontine angle. Fast spin echo magnetic resonance imaging can now be done at a cost approximating auditory brain stem response testing while providing the anatomic information of contrast-enhanced magnetic resonance imaging. Cost analysis was done in the cases of 58 patients with sudden sensorineural hearing loss by comparing the costs for routine workup and screening of acoustic neuroma with the cost of fast spin echo magnetic resonance imaging with the use of screening protocols based on literature review. The potential cost savings of evaluating patients with sudden sensorineural hearing loss with fast spin echo magnetic resonance imaging for acoustic neuroma was substantial, with a 54% reduction in screening costs. In an era of medical economic scrutiny, fast spin echo magnetic resonance imaging has become the most cost-effective method to screen suspected cases of acoustic tumors at our institution by improving existing technology while reducing the cost of providing that technology and eliminating charges for impedance audiometry, auditory brain stem response testing, and contrast-enhanced magnetic resonance imaging.

Magnetic resonance imaging for vestibular schwannoma: cost-effective protocol for referrals

2019 ◽  
Vol 133 (11) ◽  
pp. 948-952
Author(s):  
B A D Mettias ◽  
M Lyons
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Vestibular Schwannoma ◽  
Selection Criteria ◽  
Spin Echo ◽  
Waiting Times ◽  
Fast Spin Echo ◽  
Resonance Imaging ◽  
Patient Anxiety ◽  
Imaging Protocol

AbstractObjectiveVestibular schwannoma is the most common neoplasm in the cerebellopontine angle, and fast spin-echo T2-weighted magnetic resonance imaging is the most sensitive test for diagnosing it. This study evaluated the financial and time costs of unnecessary magnetic resonance imaging referrals before and after the application of a magnetic resonance imaging protocol.MethodA full audit cycle was used for the assessment. The first cycle in January 2012 was retrospective and evaluated the financial impact of current selection criteria for magnetic resonance imaging referral against standard guidelines. The second cycle in January 2014 was prospective after implementation of the protocol.ResultsThere were 46 and 112 patients who had magnetic resonance imaging during first and second cycle, respectively. Of the referrals for magnetic resonance imaging, 65 per cent versus 81 per cent of the referrals were appropriate in the first and second cycles, respectively. The relative risk was reduced from 0.5 to 0.2. The waiting times for magnetic resonance imaging scans improved.ConclusionSelection criteria for magnetic resonance imaging referral are important in reducing waiting times for scans, patient anxiety and conserving trust resources.

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