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Imaging of the audiovestibular system has become an important element for the approach to the dizzy patient. Among many imaging tools, magnetic resonance (MR) imaging has been considered to have a high sensitivity and specificity for diagnosis of lesions in the retrocochlear vestibular system as compared with computed tomography. In addition, considerable subsets of sinister central vestibular disorders with subtle clues can be identified by MR imaging. However, its high cost precludes its routine use for screening all patients with vestibular disorders. Therefore, MR imaging should be considered only to the patients with a risk of having retrocochlear lesions including vestibular schwannoma, cerebellopontine angle tumors, and demyelinating or vascular lesions in the posterior fossa. There have been efforts to identify the factors implying each of retrocochlear lesion, but no definite indication for imaging have suggested. The presenting pattern of dizziness, accompanying features, neurootological bed side and laboratory examination can provide useful information for recognizing factors suggesting retrocochlear lesions. The aim of this review was to discuss the indication for the neuro-otologic imaging in approaching to the dizzy patients.
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