MRI monitoring of small and medium-sized vestibular schwannomas: predictors of growth

Abstract

Background: Vestibular schwannomas are among the most common intracranial tumours. Their growth is difficult to predict.

Objectives: To study the evolution of small and medium-sized vestibular schwannomas (VSs) and identify factors predictive of growth.

Material and methods: This was a retrospective longitudinal study at a tertiary referral centre from January 2011 to January 2018. The inclusion criteria were radiological diagnosis of sporadic unilateral VS of stage I or II. Radiological and clinical data were analysed descriptively and by multivariate logistic regression to identify factors predictive of growth.

Results: A total of 1105 cases were discussed in multidisciplinary meetings and 336 patients were included with a mean age of 57.8 years and a mean follow-up time of 24 months. Around two thirds of these patients (62.8%) had non-progressive tumours. Factors identified as predictive of VS growth were the size at diagnosis (OR = 2.622, 95% CI, 1.50–4.66; p = .001) and internal auditory canal filling (OR = 7.672; 95% CI, 4.52–13.43; p < .001).

Conclusions and significance: Monitoring is the primary treatment modality for small or medium-sized VSs. As reported here for the first time, internal auditory canal filling is significantly associated with VS growth.

Chinese abstract

背景：前庭神经鞘瘤是最常见的颅内肿瘤之一。他们的发展很难预测。

目的：研究中小型前庭神经鞘瘤（VS）的演变过程, 探讨其发展的预测因素。

材料和方法：这是2011年1月至2018年1月在三级转诊中心进行的回顾性纵向研究。纳入标准为散发性单侧VSI期或II期的影像诊断。进行了对影像资料和临床资料进行的描述性和多元逻辑回归分析, 以确定发展的预测因素。

结果：在多学科会议上共讨论1105个病例, 包括336为患者, 平均年龄57.8岁, 平均随访24个月。约三分之二的患者（62.8%）有非进展性肿瘤。诊断时的大小（OR=2.622, 95%CI, 1.50-4.66；p = .001）和内耳道充盈（OR=7.672, 95%CI, 4.52-13.43；p < .001）是预测VS发展的因素。

结论及意义：监控是中小VS的主要治疗手段。正如本文首次报道的, 内耳道充盈与VS发展呈显著相关性。

Keywords:

• Acoustic neuroma
• vestibular schwannoma
• growth
• MRI monitoring
• risk factor

Acknowledgments

The statistical analyses, editing and translation of this article were supported by the Bibliothèque Scientifique de l’Internat de Lyon. The authors thank in particular its coordinator, Pierre Giorgio, and the first reviewer H. Maisonneuve.

Disclosure statement

The authors report no conflict of interest.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.