Yang Bentao, Li Jing, Dong Jiyong
1 Department of Radiology, Beijing Tongren Hospital, Capital Medical University , Beijing , China.
Br J Radiol. 2018 Oct;91(1090):20170957. doi: 10.1259/bjr.20170957. Epub 2018 Sep 12.
: To evaluate and compare the imaging feature of sinonasal oncocytic papilloma (OP) with inverted papilloma (IP).
: The CT and MR imaging manifestations of 17 pathology proven sinonasal OPs were reviewed and compared with 17 IPs randomly selected as a control group over the same period.
: Seventeen sinonasal OPs had unilateral occurrence and 16 of them (94.1%) had a lobulated configuration.The distribution of original sites differed significantly between OPs and IPs (p < 0.05).OPs (47.1%) particularly involved the maxillary sinus,while IPs (64.7%) usually arose from the lateral nasal wall.OPs exhibited isointense in 5 cases and grape- or patchy-like hyperintense in 12 on T weighted image, and isointense in 13 and hyperintense in 4 on T weighted image, with moderate enhancement. 10 OPs appeared as a Type II time intensity curve (TIC).There was significant difference of pre-contrast T signal intensity between OPs and IPs (p < 0.05).The prevalence of the imaging findings of "focal osteitis" (11.8% vs 94.1%) and "cystic change" (94.1% vs 17.6%) differed significantly between OPs and IPs (p < 0.05), but not for "cerebriform"sign (82.4% vs 94.1%) (p > 0.05).
: Three imaging features including high signal on Tweighted image, cystic change and only a rare association of focal osteitis may help the diagnosis of OP distinguished from IP.
: The typical imaging characteristics should prompt an accurate diagnosis of sinonasal OPs in routine clinical practice. Combination of CT and MR imaging characteristics can be more helpful in discriminating OPs from IPs.
评估并比较鼻窦嗜酸性细胞乳头状瘤(OP)与内翻性乳头状瘤(IP)的影像学特征。
回顾17例经病理证实的鼻窦OP的CT和MR成像表现,并与同期随机选取的17例IP作为对照组进行比较。
17例鼻窦OP均为单侧发病,其中16例(94.1%)呈分叶状。OP与IP的起源部位分布差异有统计学意义(p<0.05)。OP尤其好发于上颌窦(47.1%),而IP通常起源于鼻侧壁(64.7%)。OP在T加权像上5例呈等信号,12例呈葡萄状或斑片状高信号,在T2加权像上13例呈等信号,4例呈高信号,增强呈中度强化。10例OP表现为II型时间-强度曲线(TIC)。OP与IP在平扫T2信号强度上差异有统计学意义(p<0.05)。“局灶性骨炎”(11.8%对94.1%)和“囊性改变”(94.1%对17.6%)在OP与IP中的发生率差异有统计学意义(p<0.05),但“脑回样”征(82.4%对94.1%)差异无统计学意义(p>0.05)。
T2加权像上高信号、囊性改变及罕见的局灶性骨炎这三个影像学特征有助于OP与IP的鉴别诊断。
典型的影像学特征有助于在常规临床实践中准确诊断鼻窦OP。CT和MR成像特征相结合有助于更准确地区分OP与IP。