MRI - MRI Head and neck
Axial T1
Axial T2 fat sat
Axial T1 C+ fat sat
Coronal T2
Coronal T2
Axial DWI B-500 GE
Axial ADC
Do you remember which structures are present in the carotid space?
common carotid artery inferiorly and internal carotid artery superiorly; internal jugular vein; glossopharyngeal nerve (CN IX); vagus nerve (CN X); accessory nerve (CN XI); hypoglossal nerve (CN XII); sympathetic nerves; deep cervical lymph node chain.
The previously described left carotid space lesion, with imaging features consistent with a benign nerve sheath tumour, is again demonstrated. There is evidence of gradual growth when compared to imaging dating back three years ago. Otherwise it is unaltered in appearance, again demonstrating prominent high T2 signal peripherally and central low T2 signal, a feature which favours a neurofibroma/schwannoma. It remains well-circumscribed, no evidence of direct invasion, and no lymph node enlargement.
The internal carotid artery is displaced medially, and there is narrowing of the oropharynx. The internal jugular is displaced postero-laterally, compressed between the mass and the deep lobe of the parotid.
Conclusion: Continued gradual enlargement of the left carotid space benign nerve sheath tumour.