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Hypoglossal Canal Lesions: Distinctive Imaging Features and Simple Diagnostic Algorithm.

Steven M Weindling1, Christopher P Wood2, Joseph M Hoxworth3

  • 11 Department of Diagnostic Radiology, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224.

AJR. American Journal of Roentgenology
|August 17, 2017
PubMed
Summary

This study differentiates hypoglossal canal lesions, including hypoglossal schwannomas and juxtaarticular cysts, using imaging features. Identifying these lesions is crucial for appropriate treatment planning.

Keywords:
MRIcraniocervical junction juxtaarticular cysthypoglossal canalschwannoma

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Area of Science:

  • Neuroradiology
  • Head and Neck Imaging
  • Oncology

Background:

  • Lesions involving the hypoglossal canal can present with overlapping imaging features.
  • Accurate differentiation is essential for guiding patient management and treatment.

Purpose of the Study:

  • To compare the prevalence of hypoglossal canal lesions.
  • To identify distinct imaging features that differentiate hypoglossal schwannomas, juxtaarticular cysts, and other cystic lesions.

Main Methods:

  • A 15-year retrospective review of hypoglossal canal and nerve lesions was conducted.
  • Imaging features and clinical findings were documented.
  • Hypoglossal schwannomas were compared to size-matched vestibular schwannomas.

Main Results:

  • Forty lesions were identified: 16 hypoglossal schwannomas, 15 juxtaarticular cysts, and 9 purely cystic lesions.
  • Hypoglossal schwannomas showed heterogeneous enhancement, while juxtaarticular cysts exhibited thin rim enhancement.
  • Purely cystic lesions lacked enhancement and had CSF-like signal intensity.

Conclusions:

  • Hypoglossal schwannomas, juxtaarticular cysts, and nonenhancing cystic lesions can affect the hypoglossal canal.
  • Purely cystic lesions are unlikely to be schwannomas.
  • A diagnostic algorithm based on imaging and clinical findings aids in differentiating these lesions for appropriate treatment.