Fig. (3).

Axial T2 weighted fast spin echo (FSE) MR image (a) and axial T1 weighted FSE post-gadolinium T1 (b) demonstrates fluid and enhancing soft tissue filling the mastoid air cells bilaterally (asterisks), greater on the left. Note preservation of the bony labyrinths bilaterally (arrows). Coronal T2-weighted sequence (c) demonstrates preservation of the semicircular canals bilaterally (arrowheads), despite adjacent soft tissue abnormality (asterisk). Coronal T1 weighted FSE contrast enhanced T1 (d) demonstrates the fluid and enhancing soft tissue involving the mastoids bilaterally (asterisks). On the left, there is extension along the tegmen tympani with minimal adjacent dural thickening and enhancement without adjacent brain parenchymal involvement (arrow).