Abstract
BACKGROUND AND PURPOSE: SCSCs are rare. This study reviews our experience with CT and MR imaging of SCSCs.
MATERIALS AND METHODS: We retrospectively reviewed the CT and MR imaging studies as well as clinical data of 12 patients (6 men, 6 women; mean age, 41 years; range, 27–55 years) with surgicopathologic evidence of SCSC, referred to our institution between January 1999 to October 2008. Images were evaluated with respect to the location, number, morphology, attenuation/signal intensity, enhancement characteristics, and patterns of mass effect of the schwannomas.
RESULTS: The schwannomas were solitary, well-circumscribed, and medial to the carotid sheath. Seven were hypoattenuated to skeletal muscle on CT with poor postcontrast enhancement, 4 were isoattenuated, and a single lesion showed intense heterogeneous enhancement. At MR imaging, they were heterogeneously bright on T2WI with intense inhomogeneous postgadolinium enhancement. The ICA was displaced anteriorly in 9 patients with a component of lateral displacement in 8 of these patients. The ICA was in a neutral position in 2 patients and posterolaterally displaced in 1 patient. A single patient demonstrated separation of the ICA and IJV. There was splaying of the carotid bifurcation in 4 patients.
CONCLUSIONS: We present the patterns of mass effect and the spectrum of CT and MR imaging characteristics of SCSC, including certain observations that are infrequently described in the published literature.
Abbreviations
- ECA
- external carotid artery
- ICA
- internal carotid artery
- IJV
- internal jugular vein
- S
- schwannoma
- SCSC
- schwannoma of the cervical sympathetic chain
- T1WI
- T1-weighted imaging
- T2WI
- T2-weighted imaging
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