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The pterygopalatine fossa: postoperative MR imaging appearance
L L Chan1, J Chong, A M Gillenwater
1Department of Diagnostic Radiology, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
AJNR. American Journal of Neuroradiology
|August 23, 2000
Summary
Post-surgical changes in the pterygopalatine fossa (PPF) on MRI appear abnormal, mimicking tumor recurrence. Recognizing these imaging findings is crucial for accurate diagnosis in head and neck cancer patients.
Area of Science:
- Radiology
- Head and Neck Imaging
- Oncologic Imaging
Background:
- The pterygopalatine fossa (PPF) is a critical deep facial anatomical region.
- Accurate assessment of the PPF is vital for staging head and neck malignancies and detecting recurrence.
- Perineural tumor spread evaluation often involves the PPF.
Purpose of the Study:
- To characterize the postoperative magnetic resonance (MR) imaging appearance of the pterygopalatine fossa (PPF).
- To differentiate post-surgical changes from tumor recurrence in the PPF.
Main Methods:
- Retrospective review of imaging and clinical data from 10 patients.
- Inclusion criteria: surgical violation of the PPF without pre- or post-operative tumor evidence.
- Analysis of postoperative MR imaging findings in the PPF.
Main Results:
- Surgically altered PPF consistently demonstrates persistent abnormalities on MR imaging.
- Observed changes include loss of normal T1 signal hyperintensity.
- Abnormal, increased contrast enhancement is noted on fat-suppressed T1-weighted images, mimicking tumor.
Conclusions:
- Postoperative MR imaging of the PPF reliably shows abnormal findings after surgical intervention.
- These expected imaging changes can be mistaken for tumor recurrence.
- Awareness of these findings is essential to prevent misdiagnosis of recurrent disease.