Abstract:DW-MRI did not add significantly to the information gained from conventional MRI. It should be considered complimentary only to standard MRI in uncertain cases when malignancy is still a concern.
“…Studies considering DWI in paranasal sinus diseases available in literature focused essentially on ADC comparisons between groups of malignant neoplasms and benign lesions, considering a wide variety of inflammatory lesions in the group of benign lesions [ 20 , 21 , 31-37 ]. Inflammatory diseases exclusively were investigated by two studies [ 22 , 38 ] with distinct objectives and methodology.…”
Section: Discussionmentioning
confidence: 99%
“…Recently, MRI is often referred to as the preferable imaging examination in the diagnosis of inflammatory sinus disease [ 18 , 19 ] essentially when further maxillary sinus disease evaluation is needed. Diffusion-weighted MRI (DWI) is a conventional MRI complementary tool that can be employed to the depiction of sinus diseases [ 20-22 ] and analyses qualitatively water molecular random movements in intracellular medium. DWI can be translated into numerical values, named as “apparent diffusion coefficient“ (ADC) which expresses quantitatively water movement.…”
BackgroundMagnetic resonance imaging is considered a preferable imaging examination in the diagnosis of inflammatory maxillary sinus disease and can provide precise sinonasal characterization. Diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient are complementary magnetic resonance imaging tools that can be applied to the differentiation of sinus diseases. In this report, 3 cases of inflammatory maxillary sinus diseases imaging findings considering diffusion-weighted magnetic resonance imaging features were described. Additionally, a literature review considering the use of diffusion-weighted magnetic resonance imaging in inflammatory lesions is provided.MethodsThe cases reported were: presence of air-fluid levels, mucosal thickening and a mucous retention cyst. Conventional magnetic resonance imaging and apparent diffusion coefficient (ADC) maps, with ADC values were demonstrated. In the literature review, the studies considering inflammatory lesions were detailed, as well as ADC values established by investigators.ResultsADC values for presence of air-fluid levels, mucosal thickening and mucous retention cyst were respectively: 1.99 x 10-3 mm2/s; 1.83 x 10-3 mm2/s; 2.05 x 10-3 mm2/s.ConclusionsIt was observed that apparent diffusion coefficient values from the inflammatory lesions described in this report were different and apparent diffusion coefficient may be useful in the differentiation of these maxillary sinus alterations. Further larger sample investigations considering apparent diffusion coefficient values focusing in inflammatory lesions are recommended. The lack of studies considering the use of diffusion-weighted magnetic resonance imaging on inflammatory diseases diagnostic was the major limitation to the literature review.
“…Studies considering DWI in paranasal sinus diseases available in literature focused essentially on ADC comparisons between groups of malignant neoplasms and benign lesions, considering a wide variety of inflammatory lesions in the group of benign lesions [ 20 , 21 , 31-37 ]. Inflammatory diseases exclusively were investigated by two studies [ 22 , 38 ] with distinct objectives and methodology.…”
Section: Discussionmentioning
confidence: 99%
“…Recently, MRI is often referred to as the preferable imaging examination in the diagnosis of inflammatory sinus disease [ 18 , 19 ] essentially when further maxillary sinus disease evaluation is needed. Diffusion-weighted MRI (DWI) is a conventional MRI complementary tool that can be employed to the depiction of sinus diseases [ 20-22 ] and analyses qualitatively water molecular random movements in intracellular medium. DWI can be translated into numerical values, named as “apparent diffusion coefficient“ (ADC) which expresses quantitatively water movement.…”
BackgroundMagnetic resonance imaging is considered a preferable imaging examination in the diagnosis of inflammatory maxillary sinus disease and can provide precise sinonasal characterization. Diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient are complementary magnetic resonance imaging tools that can be applied to the differentiation of sinus diseases. In this report, 3 cases of inflammatory maxillary sinus diseases imaging findings considering diffusion-weighted magnetic resonance imaging features were described. Additionally, a literature review considering the use of diffusion-weighted magnetic resonance imaging in inflammatory lesions is provided.MethodsThe cases reported were: presence of air-fluid levels, mucosal thickening and a mucous retention cyst. Conventional magnetic resonance imaging and apparent diffusion coefficient (ADC) maps, with ADC values were demonstrated. In the literature review, the studies considering inflammatory lesions were detailed, as well as ADC values established by investigators.ResultsADC values for presence of air-fluid levels, mucosal thickening and mucous retention cyst were respectively: 1.99 x 10-3 mm2/s; 1.83 x 10-3 mm2/s; 2.05 x 10-3 mm2/s.ConclusionsIt was observed that apparent diffusion coefficient values from the inflammatory lesions described in this report were different and apparent diffusion coefficient may be useful in the differentiation of these maxillary sinus alterations. Further larger sample investigations considering apparent diffusion coefficient values focusing in inflammatory lesions are recommended. The lack of studies considering the use of diffusion-weighted magnetic resonance imaging on inflammatory diseases diagnostic was the major limitation to the literature review.
“…41 Several studies have shown that ADC mapping can be used to differentiate benign and inflammatory sinus disease from malignant tumors. [42][43][44] Multiparametric MRI using both ADC mapping and dynamic contrast-enhanced MR time-intensity curve analysis has also been shown to have some utility in differentiating between benign and malignant sinonasal lesions. 43 The most common sinonasal neoplasm is squamous cell carcinoma, accounting for approximately 80% of sinonasal cancers.…”
Computed tomography (CT) is often the primary imaging modality for the evaluation of sinonasal disease. For some indications, magnetic resonance imaging (MRI) may provide additional information. There are established indications for using MRI in complicated sinonasal inflammatory disease, invasive fungal sinus disease, and sinonasal mass lesions. When MRI is used in the evaluation of sinonasal disease, it is usually used as a complementary modality in addition to CT. Magnetic resonance imaging in sinonasal disease can be used to further characterize the primary sinonasal disease process and to evaluate the extent of complications such as orbital or intracranial involvement. When MRI is used in sinonasal disease, it should be evaluated in the context of the clinical situation and CT imaging features. This will help radiologists provide a meaningful differential diagnosis to assist in clinical management.
“…DWI and ADC are highly variable. When viscous protein-rich secretions are present, it may have very low ADC values (< 0.5 × 10 −3 mm 2 /s) [ 48 ]. Fig.…”
The sphenoid bone is an unpaired bone that contributes to the formation of the skull base. Despite the enormous progress in transnasal endoscopic visualisation, imaging techniques remain the cornerstones to characterise any pathological condition arising in this area. In the present review, we offer a bird’s-eye view of the developmental, inflammatory, and neoplastic alterations affecting the sphenoid body and clivus, with the aim to propose a practical diagnostic aid for radiologists based on clinico-epidemiological, computed tomography, and magnetic resonance imaging features.
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