Figure 4.

A 10-year-old boy with juvenile angiofibroma.

a. Postcontrast T1WI shows a strongly enhanced tumor in the nasopharyngeal space (arrowheads). This patient underwent presurgical embolotherapy.

b, c. Frontal view of the bilateral external carotid arteriograms (b, right; c, left). A fine contrast blush corresponding to the nasopharyngeal tumor can be seen on external carotid angiograms (arrowheads). This was fed by the right sphenopalatine artery (b, arrow), left sphenopalatine artery (c, arrow), and pharyngeal blanch of the left ascending pharyngeal artery (c, double arrow).

d. Frontal view of the right internal carotid arteriogram showing contrast blush fed by the Vidian artery (arrow) and other branches coming off from the inferolateral trunk (double arrows).

e, f. Frontal views of the right maxillary (e) and left external carotid (f) arteriograms immediately after embolization. Feeding arteries from the bilateral sphenopalatine and left ascending pharyngeal arteries were embolized using microspheres (Embosphere 300–500 μ, Merit Medical, Salt Lake City, UT, USA). The Vidian artery from the right internal carotid artery was also embolized using detachable microcoils. Bilateral external carotid arteriograms showing the disappearance of the contrast blush in the tumor.