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Mucoceles of the paranasal sinuses: MR imaging with CT correlation
P Van Tassel1, Y Y Lee, B S Jing
1Department of Diagnostic Radiology, University of Texas, M. D. Anderson Cancer Center, Houston 77030.
Abstract:
The MR findings in six cases of paranasal sinus mucoceles are described. Two basic MR appearances were encountered: either moderate to marked signal hypointensity in the expanded sinuses on T1- and T2-weighted images (four patients) or moderate to marked signal hyperintensity on T1- and T2-weighted images (two patients). These patterns appear to represent inspissated or hydrated sinus contents, respectively. CT correlation revealed hyperdense mucoceles in the decreased MR signal group and hypo- or isodense mucoceles in the increased MR signal group. Superimposed allergic Aspergillus sinusitis was also present in two patients with hypointense mucoceles on MR.
Insights
Magnetic resonance imaging (MRI) reveals two distinct appearances for paranasal sinus mucoceles, differentiating between dehydrated and hydrated contents. These findings aid in diagnosis and understanding mucocele characteristics.
Area of Science:
- Radiology
- Medical Imaging
- Otolaryngology
Background:
- Paranasal sinus mucoceles are common benign cystic lesions.
- Accurate diagnosis and characterization are crucial for appropriate management.
- Magnetic resonance (MR) imaging offers detailed soft tissue contrast for evaluating sinonasal pathology.
Purpose of the Study:
- To describe the magnetic resonance (MR) imaging findings in paranasal sinus mucoceles.
- To correlate MR signal characteristics with CT findings and mucocele content.
- To investigate the appearance of mucoceles with superimposed infections.
Main Methods:
- Retrospective review of six paranasal sinus mucocele cases.
- Analysis of MR imaging features on T1- and T2-weighted sequences.
- Correlation with computed tomography (CT) findings.
- Assessment of superimposed sinonasal conditions.
Main Results:
- Two primary MR appearances were identified: moderate to marked hypointensity (four patients) and moderate to marked hyperintensity (two patients) on T1- and T2-weighted images.
- Hypointense mucoceles on MR corresponded to inspissated (dehydrated) contents and were hyperdense on CT.
- Hyperintense mucoceles on MR corresponded to hydrated contents and were hypo- or isodense on CT.
- Two patients with hypointense mucoceles had superimposed allergic Aspergillus sinusitis.
Conclusions:
- MR imaging can differentiate between dehydrated and hydrated paranasal sinus mucoceles based on signal intensity.
- MR findings correlate with CT density and provide insights into mucocele content.
- MR imaging is valuable in evaluating complex sinonasal mucoceles, including those with fungal superinfections.