Gadolinium: The New Gold Standard for Diagnosing Cerebellopontine Angle Tumors

• All physicians involved with the diagnosis and management of patients with tumors in the temporal bone and cerebellopontine angle are faced with the challenge removing these tumors while preserving hearing. Part of the challenge is to make the diagnosis while the tumor is still small enough to attempt a hearing-conservation surgical approach. Air-contrast (air cisternography) computed tomography is the “gold standard” by which all techniques of diagnosis are compared. Most physicians, however, are reluctant to use this test as a screen for tumors because of the associated morbidity, time, and expense. We present three case reports of contrast-enhanced magnetic resonance imaging for the detection of small intracanalicular or cerebellopontine angle tumors, and review the literature of this new and exciting technology. We feel that gadolinium-enhanced magnetic resonance imaging is now the procedure of choice for evaluating patients with suspected temporal bone tumors. (Arch Otolaryngol Head Neck Surg. 1989;115:1244-1247).