Residual tumor diagnosis for glomus jugulare tumors by dynamic contrast medium MRI

To evaluate the ability of dynamic MRI to differentiate residual tumor from scar after glomus jugulare (GJ) surgery. Methods: 26 patients after GJ sur gery were examined with dynamic contrast medium MRI on a 1.5T Philips-Gyro- Scan NT. A T-1-weighted TFE sequence was performed to localise the 5 slices for the dynamic study. Subsequently, a T-1-weighted TFE sequence was used for the dynamic contrast medium study. We started contrast medium administr ation and TFE sequence at the same time. The time until acquisition of the first image was 7.4s, and the interval between two images 7 s (total time 2 .24 min). Intensity versus time studies were performed in the region of int erest. Results: 2 typical intensity versus time graphs were observed: resid ual tumors showed a rapid increase in signal intensity, followed by a "wash -out" phase, and a plateau phase in the later course. Scar showed a moderat e increase in signal intensity, followed by a plateau phase on a low intens ity level. In 9 patients, in whom tumor removal was subtotal, we saw the ty pical graph of a GJ tumor. 4 of 17 patients with complete tumor removal sho wed a typical graph like that of residual tumor, 13 of 17 patients showed t he typical graph of a scar. Conclusion: With dynamic contrast medium MRI st udies, differentiation between residual tumor and scar is possible in patie nts with prior GJ surgery.