Document Detail

CT and MR findings in neoplastic perineural spread along the vidian nerve.
MedLine Citation:
PMID:  10757009     Owner:  NLM     Status:  MEDLINE    
The aims of this article are to describe the findings of perividian tumor spread and to compare the accuracy of MRI and CT in diagnosing perineural metastasis along the vidian nerve. Moreover, the frequency of perividian metastasis in patients with head and neck cancer was evaluated. The CT and MR examinations of 98 consecutive untreated patients with histologically proven head and neck cancer were retrospectively reviewed. We considered as criteria for perineural tumor spread along the vidian nerve the following CT and MR findings: For CT (a) enlargement of the pterygoid canal, (b) erosion of its bony wall, and (c) obliteration of its normal fatty content; and for MR (a) enlargement of the vidian nerve, (b) enhancement of the nerve, and (c) obliteration of fat, particularly in the anterior part of the pterygoid canal. Ten patients met the selected criteria for perineural metastasis, which was bilateral in 3 patients, with a total of 13 vidian metastases. The CT scans demonstrated unilateral involvement of the vidian nerve in 9 patients. The MRI scans showed 13 perineural metastases. In 3 patients MR scans demonstrated involvement of four vidian nerves that appeared normal on CT examinations. The diagnostic difference between CT and MRI was statistically significant (Fisher's exact test; p = 0.04). Perineural spread along the vidian nerve is an event more frequent than previously reported and must be investigated with a careful imaging technique. Although a major limitation of our study is the lack of histological proof, the MR finding of a significant enhancement of the nerve, whether enlarged or normal in size, could be considered very suggestive of this kind of metastatic spreading, particularly if associated with simultaneous involvement of the neighboring structures (pterygopalatine fossa, foramen lacerum, trigeminal branches, etc.).
A Blandino; M Gaeta; F Minutoli; I Pandolfo
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European radiology     Volume:  10     ISSN:  0938-7994     ISO Abbreviation:  Eur Radiol     Publication Date:  2000  
Date Detail:
Created Date:  2000-04-28     Completed Date:  2000-04-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  521-6     Citation Subset:  IM    
Institute of Radiological Sciences, University of Messina, Policlinico Universitario G. Martino, Italy.
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MeSH Terms
Aged, 80 and over
Brain Neoplasms / diagnosis,  secondary*
Diagnosis, Differential
Head and Neck Neoplasms / pathology*,  radiography
Magnetic Resonance Imaging*
Middle Aged
Peripheral Nervous System Neoplasms / diagnosis,  secondary*
Pterygoid Muscles / innervation*
Reproducibility of Results
Retrospective Studies
Tomography, X-Ray Computed*

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