1 / 89

Imaging Evaluation Para nasal Sinuses

Imaging Evaluation Para nasal Sinuses. By: Ali Hekmatnia , MD Hossain Ahrar , MD. Sinonasal Overview. Sinonasal Overview. OSTIOMEATAL UNIT (OMU). Sinonasal Overview. Sinonasal Overview. Sinonasal Overview. Neoplasms of PNS. Very rare 3 % Predominately of older males

vesta
Download Presentation

Imaging Evaluation Para nasal Sinuses

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Imaging EvaluationPara nasal Sinuses By: Ali Hekmatnia, MD HossainAhrar, MD

  2. Sinonasal Overview

  3. Sinonasal Overview

  4. OSTIOMEATAL UNIT (OMU)

  5. Sinonasal Overview

  6. Sinonasal Overview

  7. Sinonasal Overview

  8. Neoplasms of PNS • Very rare 3% • Predominately of older males • Delay in diagnosis due to similarity to benign conditions • Maxillary sinus: 70% • Ethmoidsinus: 20% • Sphenoid: 3% • Frontal: 1%

  9. Benign Lesions • Papillomas • Osteomas • Fibrous Dysplasia • Neurogenic tumors • Juvenile Angiofibroma

  10. Papilloma • Fungiform: 50%, nasal septum • Cylindrical: 3%, lateral wall/sinuses • Inverted: 47%, lateral wall Unilateral Malignant degeneration in 2-13%

  11. Inverted Papilloma • CT: Lobular mass on lateral nasal wall ± maxillary/ethmoidextension or intralesionalCa++ • • MR: "Convoluted," "cerebriform“ architecture on T2 & post-gadolinium images; necrosis = coexistent carcinoma

  12. Inverted papilloma

  13. Inverted papilloma

  14. Inverted papilloma

  15. Osteomas • Benign slow growing tumors of mature bone • Location: • Frontal, ethmoids, maxillary sinuses • When obstructing mucosal flow can lead to mucocele formation • CT: Density varies from dense (compact • type) to less ossified (fibrous type)

  16. Osteoma

  17. Osteoma

  18. Mycetoma

  19. Fibrous dysplasia • Medullary bone replaced by woven bone • MonostoticvsPolyostotic • Facial bone involvement greater in polyostoticform • CT/MR: Appearance varies with amount of fibrous tissue (classic "ground-glass“ appearance) • Malignant transformation to rhabdomyosarcoma has been seen with radiation

  20. Fibrous dysplasia

  21. Fibrous dysplasia

  22. Ossifying fibroma

  23. Neurogenic tumors • 4% are found within the paranasal sinuses • Schwannomas • Neurofibromas • When associated with Von Recklinghausen’s syndrome: more aggressive (30% 5yr survival). • Imaging: Well-circumscribed mass with bone remodeling (CT) • MR: Intermediate T1 signal T2 varies with cellularity; large lesions ± cystic degeneration

  24. Nerve sheet tumor

  25. Nerve sheet tumor

  26. Nerve sheet tumor

  27. Juvenile Angiofibroma • Adolescent male patient with nasal obstruction and epistaxis • Centered at sphenopalatine foramen with spread into pterygopalatine fossa, nasal cavity, and nasopharynx • Vascular mass with flow voids and avid enhancement

  28. Juvenile Angiofibroma

  29. Juvenile Angiofibroma

  30. Malignant lesions • Squamous cell carcinoma • Adenoid cystic carcinoma • Mucoepidermoid carcinoma • Adenocarcinoma • Hemangiopericytoma • Melanoma • Olfactory neuroblastoma • Osteogenic sarcoma, fibrosarcoma, chondrosarcoma, rhabdomyosarcoma • Lymphoma • Metastatic tumors • Sinonasal undifferentiated carcinoma

  31. Squamous cell carcinoma • Patient demographics: Adult patient (95%> 40 years); M > F • Location: • Maxillary sinus (70%) • Nasal cavity (20%) • Poorly defined with aggressive bone • destruction; heterogeneous enhancement

  32. SCC

  33. Lymphoma

  34. Minor Salivary Glands Tumors • 10% of PNS Tumors • Adenoid Cystic Carcinoma • MucoepidermoidCarcinoma • Perineuralspread • Adenoid Cystic Carcinoma

More Related