Meerwein Christian M, Pazahr Shila, Soyka Michael B, Hüllner Martin W, Holzmann David
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.
Head Neck. 2020 Aug;42(8):2002-2012. doi: 10.1002/hed.26129. Epub 2020 Mar 2.
Knowledge of medial orbital wall (MOW) and anterior skull base (ASB) infiltration is of uttermost importance for staging and therapy planning of advanced sinonasal tumors.
We assessed the diagnostic performance of preoperative computed tomography (CT) and magnetic resonance imaging (MRI) for MOW and ASB infiltration compared to intraoperative exploration.
Both CT and MRI yielded higher diagnostic accuracy for MOW infiltration (Reader 1: 83.6% CT; 89.0% MRI, Reader 2: 91.8% CT, 93.2% MRI) than for ASB infiltration (Reader 1: 82.2% CT, 82.2% MRI, Reader 2: 67.7% CT, 67.7% MRI). Both modalities were equal to the gold standard, except for ASB assessment by Reader 2 with MRI. A postoperative change of T classification is common (Reader 1: 28.8%, Reader 2: 31.5%).
CT and MRI are accurate methods for the assessment of MOW infiltration. ASB assessment is challenging and false-positive and false-negative findings are common with both methods, emphasizing the need for intraoperative exploration.
了解眶内侧壁（MOW）和前颅底（ASB）浸润对于晚期鼻窦肿瘤的分期和治疗规划至关重要。
我们将术前计算机断层扫描（CT）和磁共振成像（MRI）对MOW和ASB浸润的诊断性能与术中探查进行了比较。
与ASB浸润（读者1：CT为82.2%，MRI为82.2%；读者2：CT为67.7%，MRI为67.7%）相比，CT和MRI对MOW浸润的诊断准确性更高（读者1：CT为83.6%，MRI为89.0%；读者2：CT为91.8%，MRI为93.2%）。除读者2用MRI评估ASB外，两种检查方法均等同于金标准。术后T分类改变很常见（读者1：28.8%，读者2：31.5%）。
CT和MRI是评估MOW浸润的准确方法。ASB评估具有挑战性，两种方法均常见假阳性和假阴性结果，这凸显了术中探查的必要性。
