Perbedaan Antara Gambaran Vestibular Schwannoma Dengan Meningioma Cerebellopontine Angle Pada Pemeriksaan Magnetic Resonance Imaging
Sugandhi Junilando Limthin Putra, Prof. dr. Arif Faisal, Sp.Rad. Subsp. NKL(K), DHSM; dr. Wigati Dhamiyati, Sp.Rad., Sp.Onk.Rad. Subsp.KLSSP(K)
2026 | Tesis | S2 Kedokteran Klinik
Latar belakang: Lesi cerebellopontine
angle (CPA) memiliki prevalensi rendah, tetapi penting secara klinis
karena vestibular schwannoma dan meningioma CPA sering memiliki
manifestasi klinis dan gambaran radiologis yang tumpang tindih. Pembedaan
praoperatif kedua lesi penting untuk menentukan strategi terapi, pendekatan
bedah, dan prediksi morbiditas fungsional. Penelitian ini bertujuan
membandingkan gambaran MRI antara vestibular schwannoma dan meningioma
CPA.
Metode: Penelitian ini
merupakan penelitian analitik observasional dengan desain cross sectional
dan pengambilan data retrospektif pada pasien dewasa dengan massa CPA
yang menjalani MRI kepala dengan kontras di RSUP Dr. Sardjito Yogyakarta
periode Januari 2024 - Desember 2025. Fitur MRI dianalisis oleh dua dokter
spesialis radiologi, kemudian dilakukan analisis komparatif.
Hasil: Penelitian
melibatkan 117 subjek penelitian, terdiri atas 70 vestibular schwannoma
dan 47 meningioma. Tidak terdapat perbedaan bermakna pada usia, sisi lesi,
volume tumor, maupun manifestasi klinis utama, sedangkan jenis kelamin berbeda
bermakna antara kedua kelompok (p = 0,044). Vestibular schwannoma
secara signifikan lebih sering melibatkan kanalis akustikus interna, berbentuk lobulated,
memiliki komponen solid-kistik atau kistik, menunjukkan sinyal T1 hipointens, enhancement
heterogen, kista intratumoral, serta perdarahan intratumoral. Meningioma lebih
sering berbentuk bulat, solid, isointens pada T1, dan menunjukkan enhancement
homogen. Perbedaan signifikan ditemukan pada keterlibatan kanalis akustikus
interna, bentuk, komponen tumor, sinyal T1, pola enhancement, kista
intratumoral, dan perdarahan intratumoral (p < 0>p > 0,05).
Kesimpulan: Kombinasi
karakteristik morfologi, komponen internal, sinyal T1, pola enhancement,
keterlibatan kanalis akustikus interna, kista, dan perdarahan intratumoral
membantu membedakan vestibular schwannoma dari meningioma CPA
pada MRI.
Kata kunci: Neuroma, Acoustic; Meningioma; Cerebellopontine Angle; Magnetic Resonance Imaging.
Background: Cerebellopontine angle (CPA) lesions have a low prevalence but are clinically important because vestibular schwannomas and CPA meningiomas often have overlapping clinical manifestations and radiological features. Preoperative differentiation of these two lesions is crucial for determining therapeutic strategies, surgical approaches, and predicting functional morbidity. This study aimed to compare MRI features between vestibular schwannomas and CPA meningiomas.
Methods: This was an observational, analytical study with a cross-sectional design and retrospective data collection in adult patients with CPA masses who underwent contrast-enhanced head MRI at Dr. Sardjito General Hospital, Yogyakarta, between January 2024 and December 2025. MRI features were analyzed by two radiologists, followed by a comparative analysis.
Results: The study involved 117 subjects, consisting of 70 vestibular schwannomas and 47 meningiomas. There were no significant differences in age, lesion site, tumor volume, or primary clinical manifestations, while gender was significantly different between the two groups (p = 0.044). Vestibular schwannomas were significantly more likely to involve the internal auditory canal, were lobulated, had a solid-cystic or cystic component, showed hypointense T1 signal, heterogeneous enhancement, intratumoral cysts, and intratumoral hemorrhage. Meningiomas were more often round, solid, isointens on T1, and showed homogeneous enhancement. Significant differences were found in internal auditory canal involvement, shape, tumor component, T1 signal, enhancement pattern, intratumoral cysts, and intratumoral hemorrhage (p < 0> 0.05).
Conclusion: The combination of morphological characteristics, internal components, T1 signal, enhancement pattern, internal acoustic canal involvement, cysts, and intratumoral hemorrhage helps differentiate vestibular schwannoma from CPA meningioma on MRI.
Keywords: Neuroma, Acoustic; Meningioma; Cerebellopontine Angle; Magnetic Resonance Imaging.
Kata Kunci : Neuroma, Acoustic, Meningioma, Cerebellopontine Angle, Magnetic Resonance Imaging
