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Sinochoanal polyp and its variant, the angiomatous polyp: MRI findings
S De Vuysere1, R Hermans, G Marchal
1Department of Radiology, University Hospitals Leuven, Belgium.
Abstract:
The angiomatous polyp corresponds to the vascular compromised nasochoanal part of a sinochoanal polyp. We describe the MRI characteristics of such lesions in four patients. All patients had an angiomatous polyp, in three cases as part of an antrochoanal polyp, and in one case as part of a sphenochoanal polyp. The unenhanced MR images depicted the typical appearance of a sinochoanal polyp, hypointense on T1-weighted and hyperintense on T2-weighted images. On gadolinium-enhanced MR images, the sinusal part showed little or no peripheral enhancement; however, the nasochoanal part, corresponding to the angiomatous polyp, showed strong enhancement. An angiomatous polyp mimics a hypervascular mass lesion on enhanced MR studies. The anatomic location and association with a sinusal polyp allows the correct diagnosis.
Insights
Angiomatous polyps, a vascularized part of sinochoanal polyps, show distinct MRI features. These vascular nasal polyps enhance strongly on MRI, aiding accurate diagnosis.
Area of Science:
- Radiology
- Otolaryngology
- Pathology
Background:
- Sinochoanal polyps are benign inflammatory masses originating from the sinonasal mucosa.
- Angiomatous polyps represent a specific subtype characterized by prominent vascularity.
- Accurate differentiation from other sinonasal masses is crucial for appropriate management.
Observation:
- This study describes the magnetic resonance imaging (MRI) characteristics of angiomatous polyps in four patients.
- Four cases of angiomatous polyps were identified, three as part of antrochoanal polyps and one as part of a sphenochoanal polyp.
- Unenhanced MRI showed typical sinochoanal polyp signal intensities (hypointense T1, hyperintense T2).
Findings:
- Gadolinium-enhanced MRI revealed minimal enhancement in the sinonasal portion but strong enhancement in the nasochoanal (angiomatous) portion.
- The angiomatous component demonstrated intense vascular enhancement, mimicking a hypervascular mass.
- The distinct enhancement pattern aids in differentiating these lesions.
Implications:
- Understanding these MRI features is key for radiologists interpreting sinonasal imaging.
- This characteristic enhancement pattern on MRI facilitates the correct diagnosis of angiomatous polyps.
- Accurate diagnosis prevents misidentification as aggressive vascular tumors, guiding appropriate clinical and surgical decisions.