Skull base tumors: gadodiamide injection--enhanced MR imaging--drop-out effect in the early enhancement pattern of paragangliomas versus different tumors.
A phase III trial was conducted in 40 patients with known or suspected skull base tumors to evaluate the safety and efficacy of high-dose gadodiamide injection for use as a paramagnetic contrast medium in conventional and dynamic magnetic resonance (MR) imaging. Contrast material enhancement was assessed dynamically with use of a gradient-recalled sequence. The time-intensity curve of selected regions of interest showed a reproducible dropout effect in the form of a dip in the curve during the early enhancement of the sigmoid sinus and jugular bulb; the same phenomenon was observed in all glomus tumors of the skull base, regardless of size or location. In contrast, schwannomas, meningiomas, and a variety of other lesions showed a continuous increase in the time-intensity curve. The drop-out sign, which is probably a result of a paramagnetic phenomenon during the early phase of enhancement, seems to be specific for glomus tumors. High-dose gadodiamide injection may show a specific dynamic pattern for glomus tumors, allowing differentiation from other tumors of the middle and posterior skull base.
Vogl
T J
TJ
Department of Radiology, Free University of Berlin, Rudolf Virchow Hospital, Germany.
Mack
M G
MG
Juergens
M
M
Bergman
C
C
Grevers
G
G
Jacobsen
T F
TF
Lissner
J
J
Felix
R
R
D004338:Drug Combinations; D019786:Gadolinium DTPA; D005925:Glomus Jugulare Tumor / Q000175:diagnosis; D006801:Humans; D007089:Image Enhancement; D007267:Injections; D008279:Magnetic Resonance Imaging; D008536:Meglumine; D008579:Meningioma / Q000175:diagnosis; D009442:Neurilemmoma / Q000175:diagnosis; D009942:Organometallic Compounds; D004369:Pentetic Acid; D011446:Prospective Studies; D012888:Skull Neoplasms / Q000175:diagnosis*
D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; C064925:gadodiamide; D019786:Gadolinium DTPA