Patient 1. Patient 1. A, An axial T1-weighted postcontrast image with fat saturation (600/13/2 [TR/TE/excitations]) demonstrates asymmetrical enhancement.

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Presentation transcript:

Patient 1. Patient 1. A, An axial T1-weighted postcontrast image with fat saturation (600/13/2 [TR/TE/excitations]) demonstrates asymmetrical enhancement in the right orbicularis oculi muscle (O-R, arrowhead) as compared with the contralateral side (O-L). In addition, asymmetrical, abnormally intense enhancement along the descending mastoid segment of the right facial nerve (white arrow) as compared with the left (white arrowhead) is noted, consistent with perineural spread of neoplasm. Mildly asymmetrical enhancement of right-sided muscles of mastication is related to perineural spread of tumor along V3 (not shown).B, A more inferior motion-degraded axial T1-weighted postcontrast image with fat saturation demonstrates intense enhancement in the right platysma (P, arrow) as compared with the left (arrowhead).C, An axial fast spin-echo T2-weighted image with fat saturation (4000/102/1) slightly superior to the level shown in (B) demonstrates markedly increased signal intensity in the right platysma (P, long stemmed arrow), orbicularis oris (O, short stemmed arrow), and quadratus labii inferioris (Q, small black arrowheads). The contralateral muscles are poorly seen on this fat-saturated image, but clearly are not bright.D, A coronal T1-weighted postcontrast image with fat saturation (650/13/2) demonstrates abnormally intense, continuous enhancement along the descending mastoid segment of the right facial nerve (arrowhead). The contralateral descending mastoid segment of the facial nerve is slightly posterior to this imaging plane and is not seen here Nancy J. Fischbein et al. AJNR Am J Neuroradiol 2001;22:880-884 ©2001 by American Society of Neuroradiology