使用连续 MRI 成像监测或“等待扫描”方法是中小型前庭神经鞘瘤 (VS) 患者的一种治疗选择。先前的出版物表明，与最初的等待和扫描管理相比，前期治疗没有明显的生活质量优势。然而，影像学监测取决于患者对随访的依从性。在这项研究中，作者旨在确定散发性 VS 等待扫描管理期间患者失访的比率和预测因素。进行了一项单中心研究，包括 2013 年至 2018 年接受过前期影像学监测的所有患者零星的VS。从电子病历中回顾性地获得患者数据。感兴趣的结果包括与死亡无关的随访失败以及对影像监测建议的遵守不一致。进行逻辑回归分析以评估与失访相关的因素。在为期 6 年的研究期间，270 名患者接受了散发性 VS 的初步影像学监测。肿瘤中位直径为 8.6 毫米（范围 1-28.9 毫米）。截至审查时，106 名患者（39.3%）已接受治疗，157 名患者（58.1%）被建议继续随访，7 名患者（2.6%）死于非 VS 相关原因。总共有 73 名患者 (27.0%) 在第一次治疗或死亡之前完全失访。此外，60 名患者 (22.2%) 错过了至少 1 次 MRI 随访或影像学随访延迟超过 1 年。多变量逻辑回归确定了州外居住地（OR 3.05，95% CI 1.58-5.89，p = 0.0009）和较小的肿瘤尺寸（单位 OR 每增大 1 毫米，OR 0.88，95% CI 0.83- 0.95，p = 0.0006）与失访相关。居住距离医院≥ 350 英里或在初次临床评估时肿瘤≤ 3 毫米的患者最有可能失访。只有较小的肿瘤尺寸与影像学随访不一致的风险增加相关（尺寸每增加 1 毫米，单位 OR，OR 0.92，95% CI 0.87-0.98，p = 0.007）。接受 VS 影像学监测的患者是面临失去随访和影像监测不一致的风险。肿瘤较小或居住距离治疗机构较远的患者失访的风险最高。

Imaging surveillance with serial MRI, or a "wait-and-scan" approach, is a management option for patients with small or medium-sized vestibular schwannomas (VSs). Prior publications have indicated no distinct quality of life advantage to upfront treatment compared with initial wait-and-scan management. However, imaging surveillance is dependent on patient adherence to follow-up. In this study, the authors aimed to identify rates and predictors of patient loss to follow-up during wait-and-scan management of sporadic VS.A single-center study was conducted including all patients from 2013 to 2018 who had undergone upfront imaging surveillance of sporadic VS. Patient data were retrospectively obtained from the electronic medical record. Outcomes of interest included loss to follow-up unrelated to death and inconsistent adherence to imaging surveillance recommendations. Logistic regression analyses were conducted to evaluate factors associated with loss to follow-up.Over a 6-year study period, 270 patients underwent initial imaging surveillance of a sporadic VS. The median tumor diameter was 8.6 mm (range 1-28.9 mm). At the time of censoring, 106 patients (39.3%) had received treatment, 157 (58.1%) had been advised to continue follow-up, and 7 (2.6%) had died of non-VS-related causes. In total, 73 patients (27.0%) were completely lost to follow-up prior to the first treatment or death. Additionally, 60 patients (22.2%) missed at least 1 MRI follow-up or imaging follow-up was delayed by more than 1 year. Multivariable logistic regression identified an out-of-state residence (OR 3.05, 95% CI 1.58-5.89, p = 0.0009) and a smaller tumor size (unit OR per 1-mm increase in size, OR 0.88, 95% CI 0.83-0.95, p = 0.0006) to be associated with loss to follow-up. Patients living ≥ 350 miles from the hospital or with tumors ≤ 3 mm at the time of initial clinic evaluation were most likely to be lost to follow-up. Only a smaller tumor size was associated with an increased risk of inconsistent imaging follow-up (unit OR per 1-mm increase in size, OR 0.92, 95% CI 0.87-0.98, p = 0.007).Patients undergoing imaging surveillance of VS are at risk for loss to follow-up and inconsistent imaging surveillance. Patients with smaller tumors or those living farther away from the treating institution are at highest risk for being lost to follow-up.