Learning objectives
Describe anatomy of perivertebral space on CT and MRI.
Describe the differential diagnosis in perivertebral space along with imaging features.
Know the imaging findings that can help the surgeon to change the therapeutic approach.
Background
The perivertebral space (PVS) lies deep within the neck surrounding the vertebral column,
extending from the skull base to the mediastinum.
The PVS is covered by the deep layer of the deep cervical fascia (DLDCF) and contains different tissue types,
including muscles,
bones,
nerves,
and vascular structures.
Physical examination is of limited use in evaluating this space because is deeply located.
Therefore,
imaging is very essential.
Normal anatomy
The PVS comprises the cervical soft tissues surrounding the vertebral column,
extending from the skull base to...
Findings and procedure details
Disease localization
To understand the anatomic landscape is very important to localize the lesion.
If the prevertebral muscles are lifted off the vertebral body,
then the lesion is in the prevertebral space.
In contrast,
if the lesion pushes the prevertebral muscles posteriorly to the vertebral body,
it is in the RPS.
The posterior cervical space is placed posterolateral to the paraspinal space.
The posterior cervical fat separates the two spaces and serves as an anatomic landmark to help in disease localization.
Lesions contained within the...
Conclusion
Perivertebral space can be challenging for surgeons due to its variety of disease processes and its deep location within the cervical soft tissues.
This pictorial essay provides key imaging features essential to the radiologist to make a good differential diagnosis and help to the surgeon.
References
Harnsberger H.
Perivertebral space anatomy – Imaging Issues.
Diagnostic imaging.
III-10-2-3.
Diagnostic Imaging Head and Neck.
Manitoba (Canada): Amirsys Publishing; 2004.
Hutchins T.
Perivertebral space overview.
2nd edition.
Manitoba (Canada): Amirsys Publishing; 2012.
Bohman L,
Mancuso A,
Thompson J,
et al.
CT approach to benign nasopharyngeal masses.
AJNR Am J Neuroradiol 1980;1:513–20.
Davis WL,
Harnsberger HR,
Smoker WR,
et al.
Retropharyngeal space: evaluation of normal anatomy and diseases with CT and MR imaging.
Radiology 1990;174(1):59–64.
Hoang JK,
Branstetter BF 4th,
Eastwood JD,
et al.
Multiplanar...