Imaging of the Cavernous Sinus: What the Skull Base Surgeon Needs to Know

Objective: The cavernous sinus is a complex structure susceptible to a broad range of pathologies. Computed tomography (CT) and magnetic resonance imaging (MRI) provide the opportunity to identify anatomical variants and landmarks that may impact surgical approach as well as provide important clues about diagnosis. The purpose of this abstract is to highlight the complex anatomy and imaging characteristics of cavernous sinus lesions that are essential for the skull base surgeon to know.

Methods: We performed a retrospective search of CT and MRI images through our institutional radiology database using the nuance mPower search engine for skull base lesions demonstrating cavernous sinus involvement from 2010 to 2020. Institutional electronic health records were reviewed for clinical information.

Results: Multiple CT and MRI imaging examples were identified in this pictorial essay to describe important radiologic features of a spectrum of cavernous sinus pathologies.

Conclusion: Imaging plays an essential role in the diagnosis and management of cavernous sinus lesions given anatomical proximity to complex neurovascular structures. Having strong foundational knowledge of the anatomy and imaging features of cavernous sinus lesions is critical for the skull base surgeon to guide surgical approach and clinical management ([Figs. 1] and [2]).

Fig. 1 Axial T2 shows a very T2 hyperintense lesion in the right cavernous sinus encasing the ICA without narrowing.

Fig. 2 Axial T1 post contrast image shows that the lesion demonstrates avid enhancement. Findings are consistent with a cavernous hemangioma and should not be biopsied.

Publikationsverlauf

Artikel online veröffentlicht:
15. Februar 2022