This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: ENT
A patient is suspected to have vestibular schwannoma the investigation of choice for its diagnosis is: 
Select and explain. 
A. Contrast enhanced CT scan, B. Gadolinium enhanced MRI, C. SPECT, D. PET scan
B: Gadolinium enhanced MRI
Answer: B: Gadolinium enhanced MRI 
Explanation: Ans. B (Gadolinium enhanced MRI) Vestibular schwannoma (VS) - arise from inferior vestibular division of eight nerve as from the auditory division a. MRI with gadolinium is the current standard for screening for suspected vestibular schwannomas because of the high false negative rate associated with BSERA Treatment Under 65 years - small intracranial tumors (within the internal auditory canal) may be surgically removed through the transmastoid labyrinthine route a. Larges tumors (> 3 cm) are associated with increased incidence of hearing loss, dysequilibrium, headache facial numbness, and diplopia are removed a suboccipital craniotomy b. Huge ones can only be removed combined suboccipital and translabyrinthine approach Over age 65 with slowly growing tumors, observation is the proffered treatment.