Petrous apex lesions (differential)

Entzündung

der Felsenbeinspitze rechts mit Permeation nach intrakraniell und Gasnachweis hier. CT im Knochenfenster axial.

Petrous

apicitis • Petrous apicitis - Ganzer Fall bei Radiopaedia

Petrous apex

lesions (differential) • Cholesterol granuloma - Ganzer Fall bei Radiopaedia

Dorello canal

• Petrous apex chondrosarcoma - Ganzer Fall bei Radiopaedia

Petrous apex

lesions (differential) • Left petroclival meningioma - Ganzer Fall bei Radiopaedia

Petrous apex

lesions (differential) • Acoustic schwannoma - eroding petrous apex - Ganzer Fall bei Radiopaedia

Petrous apex

lesions (differential) • Petrous apex cephalocoele - Ganzer Fall bei Radiopaedia

Petrous apex

lesions (differential) • Asymmetric fatty bone marrow of the petrous apex - Ganzer Fall bei Radiopaedia

There is a wide differential diagnosis of petrous apex lesions:

asymmetrical marrow / asymmetrical pneumatization
- non-expansile
- fat signal intensity on all sequences
petrous apex cephalocoele
- CSF signal intensity on all sequences
petrous apicitis
congenital cholesteatoma
- restricted diffusion
cholesterol granuloma
- most common cystic appearing lesion
- hyperintense signal on T1 and T2, without fat saturation
mucocele of petrous apex
- CT opacification of petrous apex air cells with expansion of cortical margins
- hyperintense T2 signal and variable T1 signal
- possible peripheral enhancement without central enhancement
benign tumors
- meningioma
- schwannoma
- paraganglioma
  - permeation of bone
  - salt-and-pepper appearance on MRI
malignant tumors
- skull base chondrosarcoma
  - most common solid lesion
- skull base chordoma
  - tends to be more midline but can involve the petrous apex
- plasmacytoma
- metastatic lesion
Langerhans cell histiocytosis
aneurysm of terminal internal carotid artery
petrous apex effusion