Imaging Analysis Of Isolated Sphenoid Sinus Disease

Objective: To analyze the imaging findings of solitary sphenoid sinus disease(ISSD)CT and MRI,summarize the imaging features,explore its clinical characteristics and application value,and correctly plan the surgery and prevent possible medical treatment for clinicians.Source damage helps.Methods:A total of 58 patients with ISSD who were admitted to the nasal ward of Shengjing Hospital affiliated to China Medical University from April to May 2018 were collected.The CT and MRI images of ISSD patients confirmed by endoscopic sinus surgery and postoperative pathology were retrospectively analyzed.According to the location of the lesion,the density,the sinus wall bone changes,the invasion around the lesion,and the enhanced scanning enhancement method and range were analyzed.Results:Of the 58 patients with ISSD,43 were the most common inflammatory lesions,including(1)fungal sphenoid sinus 28(fungal sphenoid sinusitis and allergic sphenoid sinusitis),CT showed sphenoid sinus wall Osteoclast hyperplasia,absorption,a few calcifications in the sinus,uneven density,thickening of the sphenoid sinus mucosa,MRI showed irregular density in the sphenoid sinus,part of the sinus cavity increased,the edge of the inflammation T2W1 showed a high signal,and the center showed a slight Low signal,fungal nodule T1W1 showed low signal,enhanced scan T1W1 showed marginal ring mild enhancement;(2)sphenoid sinus cyst in 8 cases,CT showed sphenoid sinusoidal round or saclike soft tissue density shadow,clear boundary,Partial density was less uniform,MRI showed a circular long T1 long T2 signal in the sphenoid sinus;(3)3 cases of sphenoid sinusitis,CT showed equal density in the sphenoid sinus,and MRI showed uniform uniform density in the sphenoid sinus of T1W1.After enhancement,the surrounding mucosa was enhanced obviously,and there was no enhancement in the center of the lesion;(4)2 cases of sphenoid sinus polyps,CT showed soft tissue density in the sphenoid sinus,mucosal thickening,partial boundary was clear,MRI elliptical T1 high signal,T2 mixed slightly High signal shadow,visible liquid level,clear boundary;(5)butterfly 2 cases of posterior nostril polyps: CT showed soft tissue mass in the posterior wall of the pharynx,which grew into the nasal cavity and sphenoid sinus.MRI showed sphenoid sinus,posterior nostril and nasal cavity.T2 high signal was the main signal,and T1 low signal was the soft tissue signal.Shadow,enhanced scanning did not see significant enhancement.(6)Cerebrospinal fluid rhinorrhea(CSFR)in 5 cases,CT showed partial sphenoid sinus bone wall depression,under-regular,discontinuous,MRI showed sphenoid sinus inside long T1,long T2 signal filling,enhanced scanning edge line Strengthened,no internal reinforcement.(7)5 cases of benign tumors(1 case of plasma cell tumor,1 case of neuroendocrine tumor,3 cases of inverted papilloma),CT showed nodular density in the sphenoid sinus,partial bone compression,absorption,destruction MRI showed that T1W1 was mainly low signal,mixed with patchy slightly higher signal,T2W1 signal was uneven,with slightly higher signal,and enhanced scanning showed uneven uneven enhancement.(8)5 cases of malignant tumor(1 case of adenoid cystic carcinoma,1 case of inverted papilloma,1 case of chordoma,2 cases of small round cell carcinoma),CT showed irregular soft tissue density in the sphenoid sinus The boundary is unclear,the local bone is osteolytic destruction,MRI shows the T1 slightly higher T2 soft tissue signal in the sphenoid sinus,the enhanced scan is obviously unevenly enhanced,and the venous phase continues to strengthen.Conclusion:CT can show the anatomical location,shape,sinus wall bone changes,sinus effusion,and surrounding invasion.MRI is a good indicator of the tissue composition,properties,enhanced scan enhancement,and surrounding tissue involvement..Combining CT and MRI to diagnose and treat isolated sphenoid sinus disease provides a road map for endoscopic fine surgery and has important clinical significance in reducing intraoperative and postoperative complications.