IMAGING OF THE JUGULAR FORAMEN - Department of Otolaryngology

IMAGING OF THE

JUGULAR FORAMEN

Dr. Mohamed Eid, MD

Lecturer of Diagnostic Imaging

Alexandria Faculty of Medicine

Bibliography

1. Ong CK, Chong VFH. Imaging of Jugular Foramen. NeuroimagClin N Am 2009; 19:469–82.

2. Davagnanam I, Chavda SV. Identification of the NormalJugular Foramen and Lower Cranial Nerve Anatomy: Contrast-Enhanced 3D Fast Imaging Employing Steady-StateAcquisition MR Imaging. AJNR Am J Neuroradiol 2008;29:574–76

3. Macdonald AJ et al. Primary Jugular Foramen Meningioma:Imaging Appearance and Differentiating Features. AJR 2004;182:373-7.

4. Rao AB et al. From the Archives of the AFIP: Paragangliomasof the Head and Neck: Radiologic-Pathologic Correlation.RadioGraphics 1999;19:1605-32.

INTRODUCTION

The jugular foramen is a complex crossroad of neurovascular structures deep in the skull base.

It is inaccessible to clinical examination, and safe surgical approach is often hindered by crucial surrounding structures.

Radiology plays a central role in the diagnostic evaluation and management planning of jugular foramen lesions.

INTRODUCTION

A jugular foramen lesion may originate from

its intrinsic contents, or arise from the

surrounding structures and involve the

foramen secondarily.

Normal variants and imaging artifacts are not

infrequent in this region, simulating diseases.

IMAGING ALGORITHM

Optimal assessment of jugular foramen diseases

requires both MR imaging and CT with thin-section

bone algorithm.

MR imaging shows the exact soft tissue extent of

lesions, whereas CT allows precise evaluation of the

surrounding bone changes.

Angiography outlines a vascular roadmap for

surgeons, and preoperative embolization may be of

value for certain hypervascular tumors.

ANATOMY

ANATOMY

ANATOMY

ANATOMY

JUGULAR BULB VARIANTS AND

PSEUDOLESIONS

Jugular bulb flow:

JUGULAR BULB VARIANTS AND

PSEUDOLESIONS

High Riding/Dehiscent Bulb:

JUGULAR BULB VARIANTS AND

PSEUDOLESIONS

Jugular Bulb Diverticulum:

PARAGANGLIOMA

PARAGANGLIOMA

PARAGANGLIOMA

SCHWANNOMA

SCHWANNOMA

SCHWANNOMA

MENINGIOMA

MENINGIOMA

MENINGIOMA

METASTATIC LESIONS

INFILTRATIVE LESIONS

PJFM JFPG JFS

Direction of

GrowthCentrifugal Superolateral Superomedial

Skull Base

Infiltration + + -

Bone ChangesPermeative-

Sclerotic

Permeative-

Destructive

Scalloped –

Well corticated

Others Dural tails Flow voids Cystic areas

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