Confused about results. Insight appreciated!

[Danienu]

Hi all!

My husband has had hearing loss for about 7 years now. Had an MRI with and without contrast in 2019 which was negative. Hearing got worse this past September and he went back to ENT and had a cat scan of the temporal bones which was also negative. He had another MRI with contrast and I’m confused about the results. Does this seem like an AN? He has a follow up with his ENT on Tuesday which should give us some clarity but until then I thought maybe you lovely folks could help me out!

Thank you so much for any info or insight you can provide? Just trying to figure out our next steps…

Here is his report

COMPARISON:  MRI FROM OCTOBER 22, 2019
TECHNIQUE:  MULTIPLANAR MR IMAGING OF THE BRAIN AT 1.5 TESLA.
DEDICATED THIN-SECTION IMAGING THROUGH CP ANGLES THE IAC
REGIONS IS INCLUDED. IMAGING WAS PERFORMED BEFORE AND AFTER
CONTRAST INJECTION.
IV CONTRAST:  20 ML INJECTED; 0 ML DISCARDED. CONTRAST AGENT:
CLARISCAN.
FINDINGS:
BRAIN PARENCHYMA: THERE ARE NO SIGNIFICANT PARENCHYMAL
LESIONS. THERE IS NO EVIDENCE OF ACUTE INTRACRANIAL
HEMORRHAGE, MASS OR ACUTE TERRITORIAL INFARCTION. THERE IS NO
MASS EFFECT, MIDLINE SHIFT OR EXTRA-AXIAL COLLECTION. THE
MAJOR INTRACRANIAL FLOW VOIDS ARE PRESERVED.
IAC/CPA: THERE IS NO EVIDENT LESION ASSOCIATED WITH THE CP
ANGLES OR IAC'S. NOTE IS MADE OF A SUBCENTIMETER ELONGATED
FOCUS OF LEFT COCHLEAR ENHANCEMENT, GROSSLY STABLE FROM THE
PRIOR STUDY.
VENTRICLES AND CISTERNS: THE VENTRICLES AND CISTERNS ARE AGE
APPROPRIATE IN APPEARANCE. THERE IS NO HYDROCEPHALUS.
SKULL, SINUSES AND SOFT TISSUES: THERE IS TRACE MUCOSAL
THICKENING WITHIN THE BILATERAL ETHMOID SINUSES. THERE IS NO
MASTOID EFFUSION.
CONCLUSION:  LEFT COCHLEAR ENHANCEMENT WHICH MAY REFLECT A
SMALL UNDERLYING SCHWANNOMA VERSUS INFLAMMATION.

[donjehle]

Hi Danienu!

Thank you for posting on the ANA Forums!

Your husband has probably already seen the ENT since you posted this, and you probably already know the answer to your question.  If so, please update us on what you found out.

I am not a physician, so I can only guess at what the radiologist wrote.  But when his conclusion reads, "Left Cochlear enhancement which may reflect a small underlying schwannoma versus inflammation," the way I interpret it in my non-clinical understanding is that the radiologist saw something quite small in or around the left cochlear, and it is possible that it is a small acoustic neuroma (also known as vestibular schwannoma) as opposed to simply inflammation in the cochlear.

Again, that is my guess, and I'm not clinically trained, so take it with a grain of salt, as they say.

Acoustic neuromas when they are very small are often difficult to see on the MRI.  They can appear like a swelling from an inflammation.  The good news is that, if it IS an acoustic neuroma, it sounds like it may be very small -- which would give your husband plenty of time to decide what treatment method he wants.

Please update us with the latest!

Best wishes!
Don

[v357139]

Interpreting an MRI always best left to the doctor.  Trying to interpret yourself you can drive yourself crazy.

[intelcells]

Hi
When acoustic neuromas are very small, the MRI frequently has trouble detecting them.  They may resemble an inflammatory swelling.  The good news is that, if it IS an acoustic neuroma, it sounds like it may be quite little, giving your husband plenty of time to choose his preferred course of treatment.