Perineural spread of head and neck tumors: How accurate is MR imaging?

William R. Nemzek, Stephen Hecht, Regina F Gandour-Edwards, Paul Donald, Kevin McKennan

Research output: Contribution to journalArticlepeer-review

126 Scopus citations


PURPOSE: Our aim was to determine the precision of MR imaging evaluation of perineural spread of head and neck tumors. METHODS: Nineteen patients had complete extirpation of head and neck tumors (10 squamous cell carcinomas, four adenoid cystic carcinomas, one poorly differentiated carcinoma, one salivary duct carcinoma, one mucoepidermoid carcinoma, one chordoma, and one meningioma) with histologic confirmation of perineural spread. Findings at presurgical contrast-enhanced MR imaging were compared with findings at pathologic examination. RESULTS: The sensitivity of MR imaging for detection of perineural spread was 95%; however, the sensitivity for mapping the entire extent of perineural spread fell to 63%. CONCLUSION: MR imaging may fail to depict microscopic foci of perineural tumor infiltration, leading to underestimation of the extent of perineural spread. Nevertheless, with careful analysis of foraminal architecture and MR enhancement patterns, one can reliably identify the presence if not the extent of perineural spread.

Original languageEnglish (US)
Pages (from-to)701-706
Number of pages6
JournalAmerican Journal of Neuroradiology
Issue number4
StatePublished - Apr 1998

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology


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