MRI signal changes in the skull base bone after endoscopic nasopharyngectomy for recurrent NPC: A serial study of 9 patients

PurposeThis study was focused on the serial changes in magnetic resonance images (MRI) of the skull-base bone that occur after endoscopic nasopharyngectomy in patients with local recurrent nasopharyngeal carcinoma (rNPC).Materials and methodsNine patients with histologically proven rNPC were enrolled in this study. Two experienced radiologists independently reviewed all presurgical and postsurgical MR images for each patient.ResultsAt 36 sites on the skull base, the MRI signal underwent a change after surgery, which took the form of a heterogeneous pattern of hypointense regions with moderate contrast enhancement on T1WI. The onset of changes ranged between 2 weeks and 3 months after surgery. For 21 of the sites, the changes subsided over the course of follow-up, while in 6 they remained stable. At 9 sites, the alteration MRI signal became more pronounced with time. Changes were more common on the homolateral side of the skull base with respect to the recurrent tumor (P < 0.05). The skull-base bone adjacent to the resection boundary had a higher incidence of signal change than nonadjacent areas (P < 0.05).ConclusionsMRI changes in the skull base bone, having a number of distinguishing characteristics, appear to be a common sequel to endoscopic nasopharyngectomy for rNPC.