Spontaneous Retropharyngeal Hematoma: Diagnosis by MR Imaging
Alberto Muñoza,
Nancy J. Fischbeina,
Joaquin de Vergasa,
Jose Crespoa and
Jose Alvarez-Vincenta
a From the Departments of Radiology (A.M.) and Otorhinolaryngology (J.V., J.C., J.A.V.), Hospital Universitario, Madrid, Spain, and the Department of Radiology (A.M., N.F.), University of California, San Francisco, San Francisco, CA.
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FIG 1. Retropharyngeal hematoma.
A, Enhanced CT scan through the supraglottis shows a well-defined, low-attenuation, midline collection ("C") that separates the posterior pharyngeal wall from the prevertebral muscles, consistent with a retropharyngeal location. No peripheral enhancement is seen. Small nonspecific left jugulodigastric nodes are present.
B and C, Sagittal T1-weighted (B) spin-echo 500/18/2 (TR/TE/excitations) and T2-weighted (C) fast spin-echo (5000/100) images show a hyperintense retropharyngeal collection that extends from the nasopharynx to the laryngopharynx (arrowheads and "C"). The airway is mildly compromised.
D, Sagittal T2-weighted fast spoiled gradient-echo image 35/6/30 (TR/TE/ °) shows the retropharyngeal collection ("C") that exhibits an outer hyperintense layer and a hypointense central core. Notice upper nasopharyngeal respiratory artifacts.
E, Axial fast inversion recovery T2-weighted 5000/136/150 (TR/Teffec/TI), at the level of the floor of the mouth, shows a high-intensity, well-defined, retropharyngeal collection ("C").
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