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Capabilities of computed tomography (CT) and magnetic resonance (MR) imaging in the diagnosis of cerebellopontine angle-petromastoid (CPA-PM) lesions were compared in 75 patients. CT and MR demonstrated 95.8% and 98.7% of the lesions, respectively. MR was often more helpful for characterization of neuromas, epidermoid cysts, exophytic gliomas, and vascular lesions, while CT was usually more informative for meningiomas, metastases, and tympanomastoid cholesteatomas. A specific diagnosis could be made with MR for most types of lesions through use of relaxation parameters and characteristic morphologic changes. Size, shape, location, and contour of the lesions, however, were generally more helpful for differential diagnosis than relaxation times. With the exception of metastatic lesions, cholesteatomas, and some meningiomas, MR was usually more helpful than CT in defining the full extent of the lesions and their relationships to contiguous structures. MR, because of its high accuracy in lesion detection, characterization, and localization, is a suitable primary diagnostic modality for evaluating patients with suspected CPA-PM lesions.

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To investigate the sodium magnetic resonance (MR) imaging characteristics of acute vasogenic edema, an experimental canine model was developed. Vasogenic edema was produced in the hemisphere of the dogs by the intraarterial infusion of hypertonic mannitol (25%). This solution opens the blood-brain barrier, allowing the influx of water, electrolytes, and proteins into the brain. The main advantage of this model over the established "cold injury" model is the lack of associated brain necrosis. Two patients with chronic vasogenic edema secondary to well-circumscribed meningiomas also underwent MR imaging. The sodium signal was markedly elevated in both clinical and experimental studies of vasogenic edema fluid compared with signal in healthy brain tissue. Extracellular sodium associated with vasogenic edema displayed MR imaging characteristics similar to that of sodium in serum. There was a trend toward a shortened T2 in edema fluid secondary to the presence of serum macromolecules.

The recent availability of high-spatial-resolution thin-section computed tomography (CT), capable of accurately depicting the thin body septa of the facial skeleton, has expanded the role that diagnostic radiology can play in the evaluation of the patient with facial trauma. A detailed knowledge of the normal CT anatomy of the face, however, is essential to optimally utilize this modality. The normal anatomy of the face was investigated in six cadavers using thin-section (1.5 mm) high-resolution CT. A systematic method of analysis that can facilitate evaluation of the face is presented. The face is conceptualized as three groups of interconnected osseous struts or buttresses that are oriented in the horizontal, sagittal, and coronal planes. Each group of struts is closely related to specific soft-tissue structures that are susceptible to injury. Sequential evaluation of each strut and its associated soft tissue assures a comprehensive evaluation of the face. While both axial and coronal sections are of value in some circumstances, the coronal ones are most helpful in accurately depicting the structures of the face that are most likely to be injured in trauma.