Evaluation of first branchial anomalies by CT and MR

Abstract

Objective: We present the spectrum of CT and MR findings of first branchial anomalies (FBAs) in our 10 year experience and attempt to integrate these anomalies into current classification systems.

Materials and methods: The hospital charts and all relevant imaging studies were retrospectively reviewed in 11 patients with pathologically proven FBAs. Radiographic analysis consisted of lesion size, morphology, location, relation to the expected course of the facial nerve, enhancement pattern, attenuation compared to CSF, and T1- and T2-weighted signal intensity. These findings were correlated with clinical symptoms and surgical findings.

Results: Seven lesions were unilocular cystic lesions within the parotid gland. Two lesions were multilobular and two consisted only of sinus tracts. Rim enhancement occurred with signs and symptoms of infection. Sinus tracts were present in 5 of 11 patients. One patient had an associated epidermoid tumor. The Arnot classification system was the most useful for categorizing our lesions.

Conclusion: Imaging was helpful in preoperative surgical planning, and none of the patients in our series had residual neurological deficits. Computed tomography was preferred to MR due to the visualization of bony detail and better capability to determine the cystic nature of these lesions.