Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Lesson
Inner Ear
49 topics, 3 hr. 16 min.
Inner Ear Preview
2 m.Inner Ear – Introduction
2 m.Anatomy of the Internal Auditory Canal (IAC)
8 m.Coronal Anatomy of the Inner Ear
4 m.Axial IAC Anatomy and Otospongiosis/Otosclerosis
6 m.Coronal IAC Anatomy and Facial Nerve Segments
6 m.MRI imaging techniques and cochlea aplasia
7 m.IAC Congenital Lesions & Syndromes - Summary
7 m.Cochlear Hypoplasia
8 m.Cochlear Nerve Deficiency, Pontine Tegmental Cap Dysplasia
5 m.Bilateral Cochlea Nerve Deficiency
5 m.Labyrinthine Dysplasia/Syndromes - Summary
10 m.Incomplete Partition Type 1
3 m.Incomplete Partition Type 2 – Summary
3 m.Bilateral Incomplete Partition Type 2
3 m.Mondini Malformation, Incomplete Partition Type II
2 m.Incomplete Partition Type II, Mondini Malformation, Semicircular Canal Abnormality
3 m.Vestibular Malformation
3 m.Enlarged Endolymphatic Sac
2 m.Incomplete Partition Type III – Summary
4 m.Down Syndrome – Summary
6 m.Down Syndrome, Semicircular Canal Deformity, Cochlear Aperture Stenosis
6 m.Down Syndrome, Aperture Stenosis
6 m.Cochlear Hypoplasia and Aperture Stenosis - Summary
4 m.Semicircular Canal (SCC) Dehiscence – Summary
4 m.Semicircular Canal (SCC) Dehiscence
3 m.Semicircular Canal (SCC) – Oblique Reformat
2 m.Inflammatory/Infectious Lesions of the Inner Ear - Summary
7 m.Labyrinthitis, Secondary to Otomastoiditis
3 m.Labyrinthine Fistula Mastoidectomy and Cochlea implant
3 m.Viral Labyrinthitis
3 m.Otospongiosis (Otosclerosis) - Summary
10 m.Bilateral Otospongiosis (Otosclerosis)
5 m.Bilateral Retrofenestral Otospongiosis
4 m.Bilateral Otospongiosis and SCC Dehiscence
3 m.Otospongiosis, Left Stapedectomy
3 m.Labyrinthitis Ossificans – Summary
11 m.Post Traumatic Labyrinthitis Ossificans
3 m.Labyrinthitis Ossificans, Cochlear Turn
2 m.Labyrinthitis Ossificans, Superior SCC
2 m.Unilateral Labyrinthine Ossificans
2 m.Petrous Apex Lesions
8 m.Right Cholesterol Granuloma
5 m.Intravestibular/Labyrinthine schwannoma
3 m.Labyrinthine Schwannoma
4 m.Left Side Labyrinthine/Vestibule Schwannoma
2 m.Endolymphatic Sac Tumor (ELST) – Summary
4 m.Endolymphatic Sac Tumor and VHL
4 m.Inner Ear Malignant Neoplasm and Trauma Closing Points
6 m.0:01
This is a companion case to the last one we
0:04
saw, in that the patient had hearing loss
0:07
on the left side.
0:09
We look at the thin section CISS image and again we see
0:13
the asymmetry in the vestibule on the right side where
0:17
it's bright, with the vestibule on the left side where
0:21
the high signal intensity endolymph and perilymph has
0:24
been replaced by soft tissue. On the post-gadolinium
0:28
enhanced scan, as you can see,
0:31
the vestibule shows contrast enhancement.
0:33
Here is the contralateral right normal
0:35
side which should not enhance.
0:37
Here we have enhancement of the vestibule in a
0:40
patient who has a labyrinthine schwannoma.
0:43
Once again,
0:43
we would be concerned about whether or not we had
0:46
pre-gadolinium enhanced T1-weighted scans that might
0:49
confirm that this is enhancement rather than fat
0:54
or blood products. And for that, once again,
0:57
the only way to do it without the pre-gad is to
1:00
do an axial reformat of the sagittal scan,
1:05
and then look for the vestibule.
1:08
Here's our cochlea.
1:10
Here's where we would expect to see the vestibule
1:13
and there is nothing bright there.
1:15
And hence we would conclude that
1:16
this represents enhancement.
1:18
This is a little trick of the trade for those people who
1:21
don't have protocols where they
1:23
do a pre-gad T1-weighted scan.
Left Side Labyrinthine/Vestibule Schwannoma
HIDEInteractive Transcript
0:01
This is a companion case to the last one we
0:04
saw, in that the patient had hearing loss
0:07
on the left side.
0:09
We look at the thin section CISS image and again we see
0:13
the asymmetry in the vestibule on the right side where
0:17
it's bright, with the vestibule on the left side where
0:21
the high signal intensity endolymph and perilymph has
0:24
been replaced by soft tissue. On the post-gadolinium
0:28
enhanced scan, as you can see,
0:31
the vestibule shows contrast enhancement.
0:33
Here is the contralateral right normal
0:35
side which should not enhance.
0:37
Here we have enhancement of the vestibule in a
0:40
patient who has a labyrinthine schwannoma.
0:43
Once again,
0:43
we would be concerned about whether or not we had
0:46
pre-gadolinium enhanced T1-weighted scans that might
0:49
confirm that this is enhancement rather than fat
0:54
or blood products. And for that, once again,
0:57
the only way to do it without the pre-gad is to
1:00
do an axial reformat of the sagittal scan,
1:05
and then look for the vestibule.
1:08
Here's our cochlea.
1:10
Here's where we would expect to see the vestibule
1:13
and there is nothing bright there.
1:15
And hence we would conclude that
1:16
this represents enhancement.
1:18
This is a little trick of the trade for those people who
1:21
don't have protocols where they
1:23
do a pre-gad T1-weighted scan.
Report
Description
Faculty
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
Tags
Temporal bone
Neuroradiology
Neoplastic
MRI
Head and Neck
Brain
© 2024 Medality. All Rights Reserved.