Head and Neck ImagingGranulation tissue, ear
vascular reparative tissue, commonly seen in the
middle ear and mastoid, in conjuction with other diseases (such as
cholesteatoma) or in isolation. The vascularized granulation tissue may produce a bluish discolouration of the tympanic membrane, causing clinical doubt as to the presence of a true hypervascular
lesion, such as a
glomus tumour. On
CT, granulation tissue causes opacification of the middle ear and mastoid without erosive changes. On
MRI, pronounced enhancement is seen after injection of gadolinium (
Fig.1). In rare cases, granulation tissue itself may behave aggressively and cause bony erosion;
MRI is very useful in such cases to differentiate it from cholesteatoma (
Fig.2). Also, see
cholesterol granuloma.
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Axial CT image (a) and gadolinium-enhanced axial T1-weighted spin-echo image (b) of the temporal bones. The opacified left otomastoid cells on the CT image correspond to strongly enhancing tissue on the MR image (arrows).
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Granulation tissue, ear, Fig.1 (a) | | Granulation tissue, ear, Fig.1 (b) | | Granulation tissue, ear, Fig.2 (a) |
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Granulation tissue, ear, Fig.2 (b) | |