A comparative review of multidetector CT angiography and MRI in the diagnosis of jugular foramen lesions

(a) Coronal CT angiogram showing avid enhancement of a right-sided glomus tumour (arrow) and (b) coronal CT angiogram showing lack of enhancement of a left-sided neuroma (arrow).

(a) Axial gadolinium-enhanced MRI images of a left-sided glomus tumour (arrow) and (b) left-sided neuroma (arrow). The enhancing characteristics of the two images are similar, with the glomus tumour not displaying the characteristic “salt and pepper” flow voids. The unenhanced T1 and T2-weighted images (not shown) were also unable to confidently differentiate the tumours.

Coronal MIP (maximum intensity projection) reconstruction showing the enlarged ascending pharyngeal feeding artery entering the glomus tumour (arrows). The normal contralateral ascending pharyngeal is also shown (arrowhead).

Volume-rendered acquisition of the venous dataset showing a right-sided glomus tumour (G) viewed from behind. The image clearly shows that the ipsilateral tranverse sinus (arrows) is the dominant draining vein (contralateral sinus shown by arrowheads). This alerts the surgeon that an attempt should be made to preserve the jugular vein at tumour resection.

CT venogram of a right-sided neuroma (arrow) showing contrast enhancement even at 60s delayed timing.