Imaging characteristics of schwannoma of the cervical sympathetic chain: a review of 12 cases.
OBJECTIVE
SCSCs are rare. This study reviews our experience with CT and MR imaging of SCSCs.


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.
Anil
G
G
Department of Radiology, Changi General Hospital, Singapore. ivyanil10@gmail.com
Tan
T Y
TY
D000328:Adult; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005682:Gadolinium; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D010524:Peripheral Nervous System Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies; D017783:Superior Cervical Ganglion / Q000000981:diagnostic imaging* / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014630:Vagus Nerve / Q000000981:diagnostic imaging / Q000473:pathology
D005682:Gadolinium