MRI SKULL BASE WITH AND WITHOUT CONTRAST:
CLINICAL HISTORY: 68-year-old woman, stage IVB squamous carcinoma of the right frontal sinus with dural, periorbital, and perineural invasion status post craniotomy.
FINDINGS:
Bones: Normal.
Soft tissues: Normal cavernous sinuses and visualized extracranial soft tissues.
Visualized skull base foramina: Normal.
Orbits: Normal.
Mastoid air cells: Clear.
Brain parenchyma: No acute hemorrhage, infarction, mass, or abnormal enhancement.
Ventricles and extra-axial spaces: Appropriate for age.
Additional comment: 8 mm enhancing right thyroid nodule (series 1601, image 26).
IMPRESSION:
1. Redemonstration of perineural spread with asymmetric thickening and enhancement of the right V3 nerve, right Meckel's cave, and right cisternal segment trigeminal nerve. There is equivocal enhancement of the right cranial nerve V1 and probable enhancement of the right V2.
2. Increased asymmetric enhancement of the right cranial nerves VII and VIII, including the right greater superior petrosal nerve, as well as cisternal and interosseous segments of the right facial nerve.
3. Interval development of enhancement in the right masticator space, likely largely related to denervation atrophy, although areas of tumor infiltration such as the infratemporal fossa region of the auriculotemporal nerve remains a consideration.
4. Unchanged postsurgical anatomy including mesh and heterogeneous signal involving the right frontal sinus.