PMC3085480_01
(Case A) Axial T1-weighted MR image with fat suppression after administration of Gadolinium at the level of the petrous bones (a) and just below the skull base (b). Indicated in a are the bilateral inflammatory changes in the petrous apices (short open arrows), bilateral involvement of the basal turn of the cochlea (long open arrows), extensive bilateral pachymeningeal involvement at the temporal lobes (short closed arrows), opacification of both mastoids and middle ears (medium closed arrows), and the mass in the left middle nasal passage extending up to the left Eustachian tube as visualized during fiber endoscopy (long closed arrow). Extension of the abscess into the parapharyngeal space, resulting in a bulge of the contour of the nasopharynx, is also shown (b, medium closed arrow).
CRIM2011-675807.001.jpg
PMC3085480_01_CRIM2011-675807.001.jpg
fig1
An MRI showed an inflammatory process of both mastoid and petrous bones with abscess formation on the left extending downwards into the parapharyngeal space resulting in a bulge of the contour of the nasopharynx (Figure 1).
(Case B) Axial contrast-enhanced CT image in bone window (a) and axial T1-weighted MR image with fat suppression after administration of Gadolinium (b) at the level of the foramen magnum. Indicated in (a) are the mass on the right side of the nasopharynx (medium open arrow) and lysis of the clivus (medium closed arrow). The abscess in the retropharyngeal space and prevertebral muscle is better appreciated on MR (b, medium open arrow); edema in the clivus and occipital bone as well as paravertebral soft tissues are also indicated (short open arrow).
CRIM2011-675807.002.jpg
PMC3085480_01_CRIM2011-675807.002.jpg
fig2
CT and MRI showed abscess formation and surrounding edema in the retropharyngeal space and prevertebral muscles on the right, accompanied by usurpation of the clivus and C0-C1 joint (Figure 2).