Catherine Jiang, Presenter: Nothing to Disclose

To study the MRI features of newly diagnosed nasopharyngeal carcinoma (NPC) in patients who presented with oculomotor nerve palsy as the very first clinical sign.

The MRI and medical records of 229 consecutive patients with newly diagnosed nasopharyngeal carcinoma(NPC) histologically were reviewed retrospectively.

A total of 22 patients with Ⅲ and/or Ⅳ and/or Ⅵ nerve palsy were found clinically(9.61%). Diplopia was the most common sign occurred in 14/22 patients. The incidence of incomplete palsy occurred in the Ⅲ,Ⅳ and Ⅵ cranial nerve was 16/44, 7/44 and 4/44, retrospectively. Of the 63 patients with MRI-demonstrated Ⅲ and/or Ⅳ and/or Ⅵ nerve involvements, the symptoms were lacking in 41 patients (65.08%). Of the 22 clinical palsied oculomotor nerve patients, there were four kinds of abnormal findings observed on MRI images. Thickening(10/44) and mass(16/44) could be found in cavernous sinus. Superior orbital fissure could appear as enlargement(4/44) and abnormal signal intensity(9/44). Thickening, obscured fatty space and enhancement could be detected in oculomotor muscles. On dynamic contrast enhanced images, the curve of the cavernous sinus and the orbital mass were in accordance with the lesion located in the nasopharynx.

Oculomotor nerve involvement could be the first clinical sign of NPC, and MRI can show the perineural extension along the Ⅲ,Ⅳ and Ⅵ cranial nerve in NPC，with important prognostic and management implications.

MRI can demonstrate the oculomotor nerves involvement in nasopharyngeal carcinoma which was importmant in staging and management.

Jiang, C, Oculomotor Nerve Palsy in Nasopharyngeal Carcinoma.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9016048.html