AHMET PEKER, ELİF PEKER, İlhan ERDEN

Benign ve malign sinonazal kitlelerin ayrımında difüzyon MR görüntüleme

Amaç: Sinonazal yerleşimli kitlelerde Apparent Diffusion Coefficient (ADC-Görünüşteki Difüzyon Katsayısı) değerlerini ölçerek benign ve malign lezyonların ayrımını yapmayı amaçladık. Yöntemler: Çalışmamızda Ekim 2011-Temmuz 2014 tarihleri arasında radyoloji ünitemize sinonazal kitle ön tanı- sı ile gönderilen ve yapılan MRG tetkikinde sinonazal kitle saptanan yaşları 16 ile 81 arasında değişen, 14 erkek 5 kadın toplam 19 hasta retrospektif olarak değerlendirildi. ADC değeri ölçümleri histopatolojik tanılarla karşılaştırıldı. Bulgular: Malign lezyonların ortalama ADC değeri (0.99±0.39) x 10-3 mm2 /sn (n=8), benign lezyonların ortalama ADC değeri (1.65±0.55) x 10-3 mm2 /sn (n=11) öl- çüldü. Benign ve malign lezyonlar arasında istatistiksel olarak anlamlı fark saptandı (p=0.012). Sonuç: Malign sinonazal tümörlerin ADC değerlerini benign lezyonlara göre istatistiksel olarak anlamlı düzeyde düşük bulduk. ADC değerinin ölçümü benign ve malign sinonazal lezyonların ayrımında faydalıdır ve rutin incelemenin bir parçası olarak kullanılmalıdır.

Discrimination of benign and malign sinonasal masses with diffusion-weighted MR imaging

Objective: Our purpose was to discriminating benign and malignant sinonasal masses with apparent diffusion coefficient (ADC) values. Methods: We retrospectively evaluated magnetic resonance (MR) images of 14 men and 5 women aged between 16 and 81 who had sinonasal masses between October 2011 and July 2014 at our radiology department. ADC values of the masses correlated with histopathological findings. Results: The mean ADC value of malignant lesions was (0.99±0.39) x 10-3 mm2 /sec (n=8), mean ADC value of benign lesions was (1.65±0.55) x 10-3 mm2 /sec (n=11). We have found statistically significant difference between ADC values of benign and malignant lesions. Conclusion: We found the mean ADC values of malignant lesions less than benign lesions and the difference was statistically significant. The mean value of ADC is useful for differentiating between benign and malignant sinonasal lesions and it can be used as a part of routine examination.

PDF

___

1. Loevner LA, Sonners Al. Imaging of neoplasms of the paranasal sinuses. Neuroimaging Clin N Am 2004;14:625-646.
2. Rao VM, El-Noueman KI. Sinonasal imaging. Anatomy and pathology. Radiol Clin North Am 1998;36:921-939.
3. Hudgins PA. Sinonasal imaging. Neuroimag Clin N Am 1996;6:319-331.
4. Maroldi R, Ravanelli M, Borghesi A, Farina D. Paranasal sinus imaging. Eur J Radiol 2008;66:372-386.
5. Allbery SM, Chaljub G, Cho N, et al. MR imaging of nasal masses. Radiographics 1995;15:1311-1327.
6. Branstetter B, Weissman J. Role of MR and CT in the paranasal sinuses. Otolaryngol Clin North Am 2005;38:1279- 1299.
7. Maeda M, Maier S. Usefulness of diffusion-weighted imaging and the apparent diffusion coefficient in the assessment of head and neck tumors. J Neuroradiol 2008;35:71-78.
8. Suzuki C, Maeda M, Hori K, et al. ADC of pituitary macroadenoma evaluated with line-scan diffusion-weighted imaging. J Neuroradiol 2007;4:228-235.
9. Wang J, Takashima S, Takayama F, et al. Head and neck lesions: characterization with diffusion-weighted echo-planar MR imaging. Radiology 2001;220:621-630.
10. Thoeny H, Keyzer F. Extracranial applications of diffusion-weighted magnetic resonance imaging. Eur Radiol 2007;17:1385-1393.
11. Razek AA, Sieza S, Maha B. Assessment of nasal and paranasal sinus masses by diffusion-weighted MR imaging. J Neuroradiol 2009;36:206-211.
12. White ML, Zhang Y, Robinson RA. Evaluating tumors and tumor like lesions of the nasal cavity, the paranasal sinuses, and the adjacent skull base with diffusion-weighted MRI. J Comput Asist Tomogr 2006;30:490-495.
13. Guo AC, Cummings TJ, Dash RC, Provenzale JM. Lymphomas and high-grade astrocytomas: comparison of water diffusibility and histologic characteristics. Radiology 2002;224:177-183.
14. Maeda M, Kato H, Sakuma H, et al. Usefulness of the apparent diffusion coefficient in line scan diffusion weighted imaging for distinguishing between squamous cell carcinomas and malignant lymphomas of the head and neck. AJNR Am J Neuroradiol 2005;26:1186-1192.
15. But-Hadzic J, Jenko K, Poljak M, et al. Sinonasal inverted papilloma associated with squamous cell carcinoma. Radiol Oncol 2011;45:267-72.
16. Vercruysse JP, De Foer B, Pouillon M, et al. The value of diffusion-weighted MR imaging in the diagnosis of primary acquired and residual cholesteatoma: a surgical verified study of 100 patients. Eur Radiol 2006;16:1461-1467.