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MR appearance of rhinoscleroma
1Department of Radiology, Mansoura Faculty of Medicine, Egypt.
Background And Purpose:
We describe the MR imaging appearance of rhinoscleroma, an endemic, chronic, granulomatous disease whose causative agent is Klebsiella rhinoscleromatis.
Methods:
The study included 15 patients (nine males and six females; mean age, 25 years; range, 13-36 years) with rhinoscleroma. MR imaging was performed in all patients. The signal intensity of the nasal masses was compared with that of fat, muscle, and CSF on both T1- and T2-weighted images. All cases were proved by histopathologic examination.
Results:
The nasal masses were bilateral and symmetrical (n = 6), asymmetrical (n = 4), or unilateral (n = 5). They extended through the anterior nares (n = 9) or posterior choana into the nasopharynx (n = 3). They obstructed the ostiomeatal units with retained secretions in the related sinuses (n = 10). On T1-weighted images, rhinoscleroma showed striking (n = 9) or mild (n = 6) high signal intensity relative to muscle and CSF, but less hyperintensity than fat. On T2-weighted images, the nasal masses showed homogeneous high signal intensity (n = 10) or heterogeneous high signal intensity associated with hypointense foci (n = 5). They were hyperintense relative to fat and muscle, but less hyperintense than CSF.
Conclusion:
The hypertrophic stage of rhinoscleroma has characteristic mild to marked high signal intensity on both T1- and T2-weighted MR images.
Insights
Rhinoscleroma, a chronic granulomatous disease caused by Klebsiella rhinoscleromatis, presents with characteristic high signal intensity on T1- and T2-weighted MR imaging. This finding aids in diagnosing the hypertrophic stage of this endemic infection.
Area of Science:
- Radiology
- Infectious Diseases
- Pathology
Background:
- Rhinoscleroma is an endemic, chronic granulomatous disease.
- It is caused by the bacterium Klebsiella rhinoscleromatis.
- Understanding its MR imaging appearance is crucial for diagnosis.
Purpose of the Study:
- To describe the magnetic resonance (MR) imaging characteristics of rhinoscleroma.
- To correlate MR findings with histopathologic confirmation.
Main Methods:
- MR imaging was performed on 15 patients diagnosed with rhinoscleroma.
- Signal intensity of nasal masses was compared to fat, muscle, and cerebrospinal fluid (CSF) on T1- and T2-weighted images.
- Histopathologic examination confirmed all cases.
Main Results:
- Nasal masses varied in laterality and extension, often obstructing the ostiomeatal units.
- On T1-weighted images, rhinoscleroma showed mild to striking high signal intensity relative to muscle and CSF.
- On T2-weighted images, masses displayed homogeneous or heterogeneous high signal intensity, hyperintense to fat and muscle, but less so than CSF.
Conclusions:
- The hypertrophic stage of rhinoscleroma exhibits characteristic high signal intensity on both T1- and T2-weighted MR images.
- MR imaging findings can aid in the diagnosis of rhinoscleroma.