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[Diagnosis of glomus jugulare tumor recurrence with dynamic contrast medium flow in MRI]
H Greess1, S Bentzien, M Gjuric
1Institut für Diagnostische Radiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg. holger.greess@idr.imed.uni-erlangen.de
Purpose:
To evaluate the ability of dynamic MRI to differentiate residual tumor from scar after glomus jugulare (GJ) surgery.
Methods:
26 patients after GJ surgery were examined with dynamic contrast medium MRI on a 1.5 T Philips-Gyro-Scan NT. A T1-weighted TFE sequence was performed to localise the 5 slices for the dynamic study. Subsequently, a T1-weighted TFE sequence was used for the dynamic contrast medium study. We started contrast medium administration and TFE sequence at the same time. The time until acquisition of the first image was 7.4 s, and the interval between two images 7 s (total time 2.24 min). Intensity versus time studies were performed in the region of interest.
Results:
2 typical intensity versus time graphs were observed: residual tumors showed a rapid increase in signal intensity, followed by a "wash-out" phase, and a plateau phase in the later course. Scar showed a moderate increase in signal intensity, followed by a plateau phase on a low intensity level. In 9 patients, in whom tumor removal was subtotal, we saw the typical graph of a GJ tumor. 4 of 17 patients with complete tumor removal showed a typical graph like that of residual tumor, 13 of 17 patients showed the typical graph of a scar.
Conclusion:
With dynamic contrast medium MRI studies, differentiation between residual tumor and scar is possible in patients with prior GJ surgery.