Cavernous sinus: correlation between anatomic and dynamic gadolinium-enhanced MR imaging findings

Dynamic magnetic resonance (MR) images were evaluated and compared with conventional T1-weighted spin-echo (SE) images obtained before and after administration of gadopentetate dimeglumine in 20 patients with normal cavernous sinuses. Starting 10 seconds after rapid injection of gadopentetate dimeglumine (0.1 mmol/kg), six to eight serial images were obtained every 30 seconds for 3-5 minutes. The venous spaces of the cavernous sinus were markedly enhanced 30 seconds after injection. Cranial nerves III and IV, V1 and VI, and V2 were seen on 75% of dynamic images each; they were seen, respectively, on 62%, 30%, and 28% of conventional postcontrast images. The medial wall was demarcated on 90% of dynamic, 15% of precontrast, and 55% of postcontrast images. A small area of connective tissue was identified within the cavernous sinus on dynamic images showing gradual enhancement. It is concluded that dynamic MR images proved useful in delineating and distinguishing abnormal tissue from normal structures.