Sinonasal organized hematoma: CT and MR imaging findings
Sinonasal organized hematoma: CT and MR imaging findings
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DOI：
10.3174/ajnr.a1042
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发表时间：
2008-06-01
影响因子：
3.5
通讯作者：
Ko, Y. -H.
中科院分区：
文献类型：
--
作者：
Kim, E. Y.;Kim, H. -J.;Ko, Y. -H.
背景和目的：鼻窦机化性血肿（OH）是一种罕见的，非肿瘤性良性疾病，可局部侵袭。这项工作的目的是描述鼻窦OH的CT和MR影像学表现。材料和方法：CT（n = 11）和MR（n = 10）图像的12例（9男3女;平均年龄，41岁;范围，12-76岁）与病理证实的鼻窦OH进行了回顾性分析。特别注意病变的位置、形状、大小、范围、内部结构、强化模式以及相关的窦壁改变。病变表现为膨胀性（n = 9）或非膨胀性（n = 3）肿块，大小从2.2到6.0 cm不等平均4.2 cm，主要累及单侧上颌窦（n = 11）或鼻腔（n = 1）。11例上颌窦病变中9例累及同侧鼻腔。8个病灶除上颌窦内侧壁外，窦壁均呈光滑糜烂。内部结构在T2加权MR图像上显示得最好，所有病变均为明显异质性低信号和等信号的混合物，周围为低信号边缘，反映了病变的组织学异质性，包括出血、纤维化和新生血管形成。在新生血管区明显的不规则结节状、乳头状或叶状强化也是所有病变的典型表现。结论：膨胀性软组织肿块、窦壁光滑糜烂、T2加权MRI上明显的不均匀信号和低信号边缘、明显的不规则结节状、乳头状或叶状强化是鼻窦OH的特征性CT和MRI表现。
BACKGROUND AND PURPOSE: Sinonasal organized hematoma (OH) is an uncommon, nonneoplastic benign condition that can be locally aggressive. The purpose of this work was to characterize the CT and MR imaging findings of sinonasal OH.MATERIALS AND METHODS: CT (n = 11) and MR (n = 10) images of 12 patients (9 men and 3 women; mean age, 41 years; range, 12-76 years) with pathologically proved sinonasal OH were retrospectively reviewed. Particular attention was put on the location, shape, size, extent, internal architecture, and enhancement pattern of the lesion and associated sinus wall change.RESULTS: The lesions were seen as an expansile (n = 9) or nonexpansile (n = 3) mass, ranging in size from 2.2 to 6.0 cm (mean, 4.2 cm), primarily involving the maxillary sinus (n = 11) or nasal cavity (n 1) unilaterally. The ipsilateral nasal cavity was also involved in 9 of 11 maxillary sinus lesions. Smooth sinus wall erosion other than the medial maxillary sinus wall was noted in 8 lesions. The internal architecture was best displayed on T2-weighted MR images on which all of the lesions were seen as a mixture of marked heterogeneous hypointensity and isointensity, surrounded by a hypointense peripheral rim, reflecting histologic heterogeneity of the lesion composed of hemorrhage, fibrosis, and neovascularization. Marked irregular nodular, papillary, or frondlike enhancement at the areas of neovascularization was also a typical finding seen in all of the lesions.CONCLUSION: An expansile soft tissue mass, smooth sinus wall erosion, marked heterogeneous signal intensity with a hypointense peripheral rim on T2-weighted MR images, and marked irregular nodular, papillary, or frondlike enhancement are characteristic CT and MR imaging findings of sinonasal OH.