Dynamic contrast enhancement of paragangliomas of the head and neck: evaluation with time-resolved 2D MR projection angiography

Abstract

Our objective was to evaluate tumor hemodynamics of paragangliomas of the head and neck. A 2D magnetic resonance projection angiography (MRPA) protocol was developed. Six patients with histologically proven paragangliomas were included in the study. The sequence protocol and data post-processing procedure were optimized in view of a high temporal resolution and maximum contrast-to-noise ratio. Image-time series of two freely orientated slabs could be obtained. Correlation analysis was performed to generate selective arterial and venous weighted angiographic images. Glomus tumors showed a rapid and intense homogeneous enhancement following the intravenous administration of contrast material. The smallest tumors investigated measured 10 mm and could be visualized clearly. Time-resolved analysis of the tumor enhancement revealed an early bolus arrival within the vascular bed of the tumor and prolonged incomplete washout indicating blood pooling. The dynamic contrast enhancement of glomus tumors can be evaluated non-invasively with MRPA providing a high temporal resolution and high image quality. The characteristic contrast enhancement of glomus tumors can be helpful in the diagnostic workup of lesions that may mimic glomus tumors.

Evaluation of Brain and Head and Neck Tumors with 4D Contrast-Enhanced MR Angiography at 3T

“…[1][2][3][4][5][6][7] It is also important for surgeons to know vasculature ahead of time, even without preoperative embolization to improve operative planning. On the basis of our results, 4D-CE-MRA may be equivalent to DSA at the primary diagnosis aimed at identifying the presence or absence of hypervascular tumors.…”

“…Head and neck tumors have been diagnosed by time-resolved contrast-enhanced MRA at 1.5T. [5][6][7] This technique combines the T1 shortening effect of gadolinium-based contrast agents, dynamic imaging, and digital subtraction and parallel imaging techniques and yields MRA images of high temporal resolution. [5][6][7] Although the use of 3T for assessing various lesions in the brain and head and neck regions by 4D-CE-MRA has been described, [8][9][10] to our knowledge, systematic evaluation of this method in patients with brain and head and neck tumors has not been performed.…”

Glomangioma da artéria digital do polegar: relato de um caso

“…Imaging studies, such as arteriography and echo-color Doppler ultrasound, are useful to evaluate glomangiomas of the extremities, particularly to make the differential diagnosis with other tumors [18][19][20][21] , but images are not conclusive.…”

Head and Neck Paragangliomas: Value of Contrast-Enhanced 3D MR Angiography

“…For CE-MRA, the diagnostic criteria were location of the lesion and, above all, early and intense enhancement very similar to the arterial vascular enhancement. 12 Consensus was always obtained in cases of discrepancy between readers.…”

“…Digital subtraction angiography (DSA) is the current imaging reference standard for assessing the vascular architecture of the tumor before embolic therapy, but this method is invasive with a complication rate of 0.5%-1%, 11 which is too high for a diagnostic examination. Consequently, some investigators have discussed the utility of more specific methods in MR imaging to differentiate paragangliomas from other tumors or vascular abnormalities (dynamic MR imaging, 12 high-dose gadodiamide-injection dynamic MR imaging, 13 or arterial and venous MR angiography [MRA] 9 ). To our knowledge, the elliptical centric contrast-enhanced MRA (CE-MRA) sequence has not been assessed for visualizing paragangliomas and differentiating them from other lesions.…”