비부비동 반전성 유두종의 전산화 단층촬영상과 자기공명영상의 분석

Evaluation of Computed Tomography and Magnetic Resonance Imaging of Sinonasal Inverted Papilloma

확실한 자기공명영상의 효과를 판정하기 위해서는 아직도 증례가 많이 부족한 것이 사실이지만 본 연구의 결과에서도 알 수 있듯이 반전성 유두종에 있어 술전 자기공명영상으로 종양의 범위와 위치를 구별하는데 탁월한 효과를 확인하였다. 앞으로도 많은 환자를 대상으로 체계적인 연구가 이루어져야 하겠고 향후 지속적인 자기공명영상 촬영술의 발달이 뒷받침 된다면 좀 더 정확한 결과를 얻을 수 있을 것으로 기대된다.

Background: Computed tomography (CT) is commonly used to evaluate the degree of sinus involvement in cases of inverted papilloma (IP). However, CT cannot differentiate tumor from adjacent inflammatory mucosa or retained secretions. By contrast, magnetic resonance imaging (MRI) has been reported to be useful in distinguishing IP from paranasal sinusitis. This study investigated whether preoperative assessment with MRI and CT accurately predict the extent of IP.1) Materials and methods: CT and MRI were retrospectively reviewed in 9 cases of IP. Patients were categorized into stages based on CT and MRI findings, according to the staging system proposed by Krouse. The involvement of IP in each sinus was also assessed. Results: Differentiation of IP from inflammatory disease may be more successful in routine cases where the inflammatory mucosa has low signal intensity on T1-weighted images and very high signal intensity on T2-weighted images. CT imaging could not differentiate tumor from adjacent inflammatory mucosa or retained secretions. Conclusion: Preoperative MRI of IP can predict the location and extent of the tumor involvement in the paranasal sinuses and sometimes predicts malignant changes.