Fig. 12

Perineural spread of ROCM detected on post-operative follow-up imaging. Axial CT image (a), obtained using bone algorithm, reveals slight widening of the right PPF (thin arrow). Unenhanced axial T1W image (b) of the same patient confirms soft tissue (thin arrow) within the right PPF. Note the loss of normal fat signal within the right vidian nerve canal (thick arrow), compared to the contralateral side (dotted arrow). CE FS axial T1W image (c) reveals abnormal enhancement of the soft tissue within the right vidian nerve canal (thick arrow). The diagnosis of perineural invasion of MCR was suggested. There was no obvious enhancement along the greater superior petrosal nerve detected at the time of scanning