Ruben Sebben, MD, at Dr Jones and Partners Medical Imaging (Adelaide, Australia) • Image data captured via the Aquilion 16-slice CT from Toshiba America Medical Systems (Tustin, Calif); advanced visualization and analysis performed using Voxar 3D from Barco (Duluth, Ga)

An 80-year-old female presented with a pulsatile right neck mass. Sebben ordered a CT angiography to determine the relationship of the tumor to the carotid arteries; he obtained multidetector CT images from the aortic arch to the Circle of Willis. Bolus-tracking software was used to visually monitor the ascending aorta for peak enhancement and to trigger a dual-phase injection of nonionic contrast. A foot injection was used to reduce beam-hardening artifact in the ascending aorta by eliminating the dense contrast in the subclavian vein, and the feet were raised 45°. The data set was transferred to the visualization and analysis software to produce a series of maximum intensity projection (MIP) and 3-D color volume-rendered images. What were the findings?

Findings and Diagnosis

A 24- x 16-mm ovoid lesion was demonstrated just above the right carotid bifurcation, splaying the internal and external carotid branches anteriorly and laterally, respectively. The lesion showed dense peripheral rim of enhancement with a relative lack of central enhancement. Appearances were suggestive of a carotid body tumor with respect to location and enhancement characteristics. The common and internal carotid artery on both sides appeared disease-free and of normal caliber.