J Otolaryngol Ophthalmol Shandong Univ ›› 2018, Vol. 32 ›› Issue (4): 37-42.doi: 10.6040/j.issn.1673-3770.0.2018.135

Previous Articles     Next Articles

Computed tomography and magnetic resonance imaging features of maxillary hemorrhagic necrotizing polyps

ZHA Yang, LÜ Wei, QI Fang, WANG Xiaowei, GAO Zhiqiang   

  1. Department of Otolaryngology Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
  • Received:2018-03-14 Online:2018-07-20 Published:2018-07-20

Abstract: Objective To improve the accuracy of preoperative diagnosis by determining the computed tomography(CT)and magnetic resonance imaging(MRI)features of maxillary hemorrhagic necrotizing polyps. Methods We retrospectively reviewed 14 cases of maxillary hemorrhagic necrotizing polyps diagnosed and operated in the last 3 years. We studied the CT and MR images of these patients and determined the imaging features of the disease and the key points for differential diagnosis. Results The main features observed on CT imaging included an expansive lesion that led to bone destruction and a soft tissue mass extending to the middle meatus. The main portion of the lesion had intermediate signal intensity on T1-weighted imaging(T1WI)and high signal intensity on T2WI, surrounded or divided by bands or strips of low signal intensity on T2WI. The “embryo sign” on enhanced T1WI is a unique feature of the disease. Some cases have similar CT imaging features to those of fungal sinusitis, inverted papilloma, and maxillary carcinoma. However, these diseases have different features on MRI, which can provide more information for differential diagnosis. Conclusion Compared with CT alone, combined CT and MRI can provide more information on maxillary hemorrhagic necrotizing polyps to enable surgeons to make a more accurate diagnosis before surgery. It is useful in the planning of endoscopic surgery and communicating with patients.

Key words: Maxillary sinus, Inverted papilloma, Hemorrhage, Maxillary sinus neoplasm, Polyps

CLC Number: 

  • R765.23
[1] Pang W, Hu L, Wang H, et al. Organized hematoma: an analysis of 84 cases with emphasis on difficult prediction and favorable management[J]. Otolaryngol Head Neck Surg, 2016, 154(4):626-633.
[2] Choi SJ, Seo ST, Rha K, et al. Sinonasal organized hematoma: clinical features of seventeen cases and a systematic review[J]. Laryngoscope, 2015, 125(9):2027-2033.
[3] Kim JS, Oh JS, Kwon SH. The increasing incidence of paranasal organizing hematoma: a 20-year experience of 23 cases at a single center[J]. Rhinology, 2016, 54(2):176-182.
[4] 董怿,周兵,王成硕,等. CT与MRI检查对单侧上颌窦病变的诊断价值[J]. 中华耳鼻咽喉头颈外科杂志,2013,48(11):895-900. DONG Yi, ZHOU Bing, WANG Chengshuo, et al. CT and MRI diagnosis of lesions in unilateral maxillary sinus[J]. Chin J Otorhinolaryngol Head Neck Surg, 2013, 48(11):895-900.
[5] 索方方. 上颌窦鼻腔出血坏死性鼻息肉的CT诊断价值[J].罕少疾病杂志, 2017,24(2):1-2,5. SUO Fangfang. The diagnostic value of CT in hemorrhagic and necrotic polyps of maxillary sinus and nasal cavity[J]. J Rare Uncom Diseas, 2017, 24(2):1-2,5
[6] Hur J, Kim JK, Byun JS, et al. Imaging characteristics of sinonasal organized hematoma[J]. Acta Radiol, 2015, 56(8):955-959.
[7] Kim EY, Kim HJ, Chung SK, et al. Sinonasal organized hematoma: CT and MR imaging findings[J]. AJNR Am J Neuroradiol, 2008, 29(6):1204-1208.
[8] Ginat DT, Moonis G. Case 217: sinonasal organized hematoma[J]. Radiology, 2015, 275(2):613-616.
[9] 汪韦平,曹志伟. 上颌窦出血性息肉的影像学分析[J]. 临床耳鼻咽喉头颈外科杂志,2017, 31(15):1164-1167,1173. WANG Weiping, CAO Zhiwei. Radiographic analysis for infarcted angiomatous polyps in maxillary sinus[J]. J Clin Otorhinolaryngol Head Neck Surg, 2017, 31(15):1164-1167,1173.
[10] 李毅敏,詹阿来,黄庆文. HRCT及MRI对鼻腔-副鼻窦出血坏死性息肉及内翻性乳头状瘤的鉴别诊断价值[J]. 医学影像学杂志,2016,26(6):967-971. LI Yimin, ZHAN Alai, HUANG Qingwen. The value of differential diagnosis between inverted papilloma and hemorrhagic necrotic nasal polyps in nasal cavity and sinus by HRCT and MRI[J]. J Med Imag, 2016, 26(6):967-971.
[1] SONG Xiaoyu, ZHANG Yu, LI Chenglin, SONG Xicheng. Enhanced recovery after surgery for the treatment of chronic rhinosinusitis with nasal polyps [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(5): 9-12.
[2] HUANG Yuan, BA Luo, LI Bo, YU Wenxing, YANG Fangli, DU Jintao. Transcription factor NKX2-1 regulates eosinophilic inflammation in chronic rhinosinusitis with nasal polyps [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 17-23.
[3] CHEN Wangxing, ZHAO Xue, LIU Yan, LIU Yue, JIN Chunshun. Psychological status of patients with deviated nasal septum or chronic sinusitis with nasal polyps [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 24-27.
[4] Effect of short-term glucocorticoid inhalation on nasal symptoms and adrenocortical function in patients with eosinophilic chronic sinusitis accompanied by nasal polyps. Effect of short-term glucocorticoid inhalation on nasal symptoms and adrenocortical function in patients with eosinophilic chronic sinusitis accompanied by nasal polyps [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 28-31.
[5] LI Huabin, LAI Yuting. Pathogenesis, diagnosis, and treatment of chronic rhinosinusitis [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(3): 4-9.
[6] YU Qianqian, GUAN Ge, ZHANG Niankai, LI Na, WEN Junfeng, LIU Tingting, LIAN Yuanyuan. Characteristics of respiratory epithelial adenomatoid hamartomas in the nasal olfactory cleft on computed tomography [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(3): 76-81.
[7] LI Hongmei, WANG Lan, GAO Zhaohui, WANG Ying, XUE Jinmei. The expression and significance of p-ERK2/ ERK2 in nasal polyps [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(3): 42-46.
[8] ZHANG Jie, GONG Qi. Clinical significance of eosinophils and neutrophils in blood and allergic reaction in patients with chronic rhinosinusitis [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(3): 54-57.
[9] GAN Bin, ZHANG Yongju, XU Anting. BRF2 in the pathogenesis of chronic rhinosinusitis with nasal polyps [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(3): 47-53.
[10] WANG Yuan, ZHOU Han, LIU Xiaojing, ZHANG Liqing, ZHAO Qing, FENG Jian, DONG Weida. Surgical strategies for nasal inverted papilloma and corresponding recurrence rates [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(2): 79-83.
[11] CUI Xiao, YAN Aihui.. Endoscopic anterior prelacrimal recess surgery for treatment of inverted papillomas. [J]. J Otolaryngol Ophthalmol Shandong Univ, 2017, 31(6): 49-52.
[12] ZHI Lili, SONG Daoliang. Expressions of eosinophils and IL5 in antrochoanal polyps and nasal polyps. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(4): 43-46.
[13] LUN Jie, ZHANG Ya′nan. Analysis on the factors related to the recurrence of chronic rhinosinusitis with nasal polyps. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(3): 80-83.
[14] KANG Zonghui, XIA Siwen, HU Xianhui, CHEN Chunxiao, ZHENG Yingsong, HUANG Yideng. Combined middle meatus and prelacrimal recess approach for treatment of fungal maxillary sinusitis. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(6): 33-36.
[15] XU Lei, ZHU Juanfen, CHENG Lei. Comparison of three surgical methods in adult patients undergoing tonsillectomy. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(6): 49-52.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] ZHANG Ying, WU Xin-yi . Investigation on awareness and health education of microbial keratitis among a community population[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2010, 24(4): 52 -54 .
[2] LI Wenjing, SHEN Jiaquan, WANG Cong
.

Application of OCT in acute primary angleclosure glaucoma

[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2009, 23(2): 86 -88 .
[3] WANG Yong-bo, SHI An-na, SHI Xun, JIN Yu, LIU Wei-feng. Relationship between photoreceptor cell layer and best corrected visual acuity (BCVA) in patients with retinal vein occlusion[J]. J Otolaryngol Ophthalmol Shandong Univ, 2013, 27(1): 78 -80 .
[4] CHEN Zhi-xi1, LIU Yang-yun2, ZHOU Wen-fang1, ZHANG Jin-ping1, LUO Xu-yong1, YE Xue-meng1, XIONG Qi-bin1, LIU Huo-wang3. Diagnosis, treatment and biocharacteristics of myoepithelial Carcinoma in head and neck[J]. J Otolaryngol Ophthalmol Shandong Univ, 2013, 27(6): 22 -25 .
[5] LI Junyi, LI Xiumei, WAN Jingming, BI Jingyu, LIU Juan, XU Hualin, JIANG Yan, LI Na. Establishment of a standardized model of traumatic optic neuropathy in cats[J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 43 -47 .
[6] WANG Gang, WU Wei, WANG Lei, LIU Hongdan, XU Xiaohang, XU Bingxin, DING Ruiying, ZHOU Ying, HAN Haolun, GONG Jing,LI Baowei, SUN Zhezhe. Correlation analysis between Ryan index and reflux symptom index and reflux finding score, in the diagnosis of[J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 48 -52 .