MR imaging of the inner ear: Comparison of a three-dimensional fast spin-echo sequence with use of a dedicated quadrature-surface coil with a gadolinium-enhanced spoiled gradient-recalled sequence

PURPOSE: To prospectively evaluate the sensitivity and specificity of magnetic resonance (MR) imaging in the inner ear with a long echo train, three-dimensional (3D), asymmetric Fourier-transform, fast spin-echo (SE) sequence with use of a dedicated quadrature-surface phased-array coil to detect vestibular schwannoma in the cerebellopontine angle and the internal auditory canal. MATERIALS AND METHODS: In 205 patients (410 ears) with ear symptoms, 1.5-T MR imaging was performed with both unenhanced 3D asymmetric fast SE and gadolinium-enhanced 3D spoiled gradient-recalled (SPGR) sequences with use of a quadrature-surface phased-array coil. The 3D asymmetric fast SE images were reviewed by two radiologists, with the gadolinium-enhanced 3D SPGR images used as the standard of reference. RESULTS: Nineteen lesions were detected in the 410 ears (diameter range, 2-30 mm; mean, 10.5 mm +/- 6.4; [standard deviation]; five lesions were smaller than 5 mm). With 3D asymmetric sensitivity, specificity, and accuracy, respectively, were 100%, 99.5%, and 99.5% for observer 1 and 100%, 99.7%, 99.8% for observer 2. CONCLUSION: The unenhanced 3D asymmetric fast SE sequence with a quadrature-surface phased-array coil allows the reliable detection of vestibular schwannoma in the cerebellopontine angle and internal auditory canal.