ABSTRACT
The diagnostic contributions of computed tomography (CT) and magnetic resonance (MR) imaging were compared in 12 patients with benign intratemporal vascular tumors (hemangioma or vascular malformation). The tumors included six in the internal acoustic canal and six in the geniculate ganglion region. Clinical and histologic correlations were made. Two of the six patients with tumors in the internal acoustic canal underwent CT, and both required gas cisternography to show the tumor. Five patients in that group underwent MR imaging, and all five studies showed the tumor. All six patients with geniculate ganglion tumors underwent CT. Results in one study were questionable, and five showed the tumor. Five patients in this group underwent MR imaging, but the MR findings were positive in only two cases. MR imaging should therefore be performed before CT in the evaluation of facial nerve dysfunction, as it demonstrated all tumors in the internal acoustic canal and some in the geniculate ganglion region. If MR findings are negative, CT should then be performed to rule out a possible geniculate ganglion lesion.
Subject(s)
Cranial Nerve Neoplasms/diagnosis , Facial Nerve Diseases/diagnosis , Facial Nerve , Geniculate Ganglion , Hemangioma/diagnosis , Intracranial Arteriovenous Malformations/diagnosis , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
Eleven patients each with a benign intratemporal vascular tumor (hemangioma or vascular malformation) were assessed with computed tomography (CT). Clinical, surgical, and histologic correlations were also available. On CT scans, most of the 11 tumors were smaller than 10 mm. Four occurred in or around the internal acoustic canal, six at the geniculate ganglion, and one at the posterior genu. The involved bone margins were often unsharp, and "honeycomb" bone or intratumoral bone spicules were sometimes present. Intratemporal vascular tumors cause profound nerve deficits despite their small size and must be resected early to salvage nerve function.
Subject(s)
Brain Neoplasms/diagnostic imaging , Hemangioma/diagnostic imaging , Adult , Arteriovenous Malformations/diagnostic imaging , Arteriovenous Malformations/pathology , Brain Neoplasms/pathology , Female , Hemangioma/pathology , Humans , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
Gas-CT cisternography is a simple and accurate procedure for detection of small acoustic nerve tumors. Review of one of the largest series in a single institution found that 98% of the studies clearly showed the presence or absence of tumors. The diagnostic pitfalls of the small number of studies in which significant errors were made, or could have been made, are discussed. It is concluded that certain situations appear to call for extra caution: (a) when the filling defect does not show a convex surface, (b) when the amount of cisternal gas is marginal, and (c) when the canal is small. In such situations careful attention to details and healthy skepticism may avert potential errors.