SLOW-FLOW PHENOMENA IN MAGNETIC-RESONANCE-IMAGING OF THE JUGULAR BULBMASQUERADING AS SKULL BASE NEOPLASMS

Enhancement in the region of the jugular foramen on magnetic resonance imaging (MRI) is highly sensitive to the presence of a skull base neo plasm. Unfortunately, this imaging method lacks the specificity to be the sole criterion in the diagnosis of a lesion of the jugular foramen . Although well described in the radiological literature, the phenomen on of gadolinium enhancement of the relatively static blood in the jug ular system continues to be erroneously diagnosed as glomus jugulare t umor. Instances of this phenomenon present in patients referred to our practice for surgical opinions before radiation therapy and/or defini tive resection will be presented. The purpose of this communication is to bring this potential treatment pitfall to the attention of the neu rotology community. Treatment planning for lesions of the lateral skul l base cannot singularly be based on MRI findings but requires a healt hy skepticism satisfied only by more complete evaluation.