Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Superior Cervical Sympathetic Ganglion: Normal Imaging Appearance on 3T-MRI

  • Lee, Joo Yeon (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Lee, Jeong Hyun (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Song, Joon Seon (Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Song, Min Jeong (Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Hwang, Seung-Jun (Department of Anatomy and Cell Biology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Yoon, Ra Gyoung (Department of Radiology, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine) ;
  • Jang, Seung Won (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Park, Ji Eun (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Heo, Young Jin (Department of Radiology, Busan Paik Hospital, Inje University College of Medicine) ;
  • Choi, Young Jun (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Baek, Jung Hwan (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center)
  • Received : 2015.08.03
  • Accepted : 2016.06.10
  • Published : 2016.09.01
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Abstract

Objective: To identify superior cervical sympathetic ganglion (SCSG) and describe their characteristic MR appearance using 3T-MRI. Materials and Methods: In this prospective study, we recruited 53 consecutive patients without history of head and neck irradiation. Using anatomic location based on literature review, both sides of the neck were evaluated to identify SCSGs in consensus. SCSGs were divided into definite (medial to internal carotid artery [ICA] and lateral to longus capitis muscle [LCM]) and probable SCSGs based on relative location to ICA and LCM. Two readers evaluated signal characteristics including intraganglionic hypointensity of all SCSGs and relative location of probable SCSGs. Interrater and intrarater agreements were quantified using unweighted kappa. Results: Ninety-one neck sites in 53 patients were evaluated after exclusion of 15 neck sites with pathology. Definite SCSGs were identified at 66 (73%) sites, and probable SCSGs were found in 25 (27%). Probable SCSGs were located anterior to LCM in 16 (18%), lateral to ICA in 6 (7%), and posterior to ICA in 3 (3%). Intraganglionic hypointensity was identified in 82 (90%) on contrast-enhanced fat-suppressed T1-weighted images. There was no statistical difference in the relative location between definite and probable SCSGs of the right and left sides with intragnalionic hypointensity on difference pulse sequences. Interrater and intrarater agreements on the location and intraganglionic hypointensity were excellent (${\kappa}$-value, 0.749-1.000). Conclusion: 3T-MRI identified definite SCSGs at 73% of neck sites and varied location of the remaining SCSGs. Intraganglionic hypointensity was a characteristic feature of SCSGs.

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