PERINEURAL SPREAD OF HEAD AND NECK TUMORS - HOW ACCURATE IS MR-IMAGING

PURPOSE: Our aim was to determine the precision of MR imaging evaluati on of perineural spread of head and neck tumors. METHODS: Nineteen pat ients had complete extirpation of head and neck tumors (10 squamous ce ll carcinomas, four adenoid cystic carcinomas, one poorly differentiat ed carcinoma, one salivary duct carcinoma, one mucoepidermoid carcinom a, one chordoma, and one meningioma) with histologic confirmation of p erineural spread. Findings at presurgical contrast-enhanced MR imaging were compared with findings at pathologic examination. RESULTS: The s ensitivity of MR imaging for detection of perineural spread was 95%; h owever, the sensitivity for mapping the entire extent of perineural sp read fell to 63%. CONCLUSION: MR imaging may fail to depict microscopi c foci of perineural tumor infiltration, leading to underestimation of the extent of perineural spread. Nevertheless, with careful analysis of foraminal architecture and MR enhancement patterns, one can reliabl y identify the presence if not the extent of perineural spread.