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| Ruben Sebben, MD, at Dr Jones and Partners Medical Imaging (Adelaide, Australia) ? Image data captured via the Aquilion 16-slice CT from Toshiba America Medical Systems (Tustin, Calif); advanced visualization and analysis performed using Voxar 3D from Barco (Duluth, Ga) |
An 80-year-old female presented with a pulsatile right neck mass. Sebben ordered a CT angiography to determine the relationship of the tumor to the carotid arteries; he obtained multidetector CT images from the aortic arch to the Circle of Willis. Bolus-tracking software was used to visually monitor the ascending aorta for peak enhancement and to trigger a dual-phase injection of nonionic contrast. A foot injection was used to reduce beam-hardening artifact in the ascending aorta by eliminating the dense contrast in the subclavian vein, and the feet were raised 45?. The data set was transferred to the visualization and analysis software to produce a series of maximum intensity projection (MIP) and 3-D color volume-rendered images. What were the findings?
Findings and Diagnosis
A 24- x 16-mm ovoid lesion was demonstrated just above the right carotid bifurcation, splaying the internal and external carotid branches anteriorly and laterally, respectively. The lesion showed dense peripheral rim of enhancement with a relative lack of central enhancement. Appearances were suggestive of a carotid body tumor with respect to location and enhancement characteristics. The common and internal carotid artery on both sides appeared disease-free and of normal caliber.
