Ear and audiology: MRI without contrast for retrocochlear screening: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Ear and audiology: MRI without contrast for retrocochlear screening

Sample item

A 55-year-old with asymmetric sensorineural hearing loss and tinnitus has severe renal impairment, so gadolinium should be avoided. Which MRI sequence can still screen the internal auditory canal for a vestibular schwannoma?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. High-resolution heavily T2-weighted sequence (CISS or FIESTA)

Heavily T2-weighted thin-slice sequences show the fluid-filled internal auditory canal, so a nerve-sized filling defect can be seen without contrast. Gadolinium-enhanced T1 remains the gold standard, but this sequence is an accepted screening alternative.

Option by option

  • A. Time-of-flight MR angiography

    MR angiography images vessels and is used for vascular tinnitus, not to screen the nerves.

  • B. High-resolution heavily T2-weighted sequence (CISS or FIESTA) (correct)

    Correct. A thin-slice heavily T2-weighted sequence outlines the canal contents and nerves without contrast.

  • C. Pre-contrast T1-weighted sequence

    Pre-contrast T1 shows the tumour poorly since enhancement is needed to show small intracanalicular lesions.

  • D. Diffusion-weighted imaging of the brain

    Diffusion-weighted brain imaging screens for infarction and cholesteatoma recurrence, not for the nerve bundle in the canal.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is B, High-resolution heavily T2-weighted sequence (CISS or FIESTA). Heavily T2-weighted thin-slice sequences show the fluid-filled internal auditory canal, so a nerve-sized filling defect can be seen without contrast.

Why is "Time-of-flight MR angiography" not the answer?

MR angiography images vessels and is used for vascular tinnitus, not to screen the nerves.

Why is "Pre-contrast T1-weighted sequence" not the answer?

Pre-contrast T1 shows the tumour poorly since enhancement is needed to show small intracanalicular lesions.

Why is "Diffusion-weighted imaging of the brain" not the answer?

Diffusion-weighted brain imaging screens for infarction and cholesteatoma recurrence, not for the nerve bundle in the canal.

What concept does this question test?

It tests Ear and audiology: MRI without contrast for retrocochlear screening in ENT. Gadolinium-enhanced T1 remains the gold standard, but this sequence is an accepted screening alternative.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Ear and audiology: MRI without contrast for retrocochlear screening?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.