Affiliation:
1. Department of Dental Informatics and Radiology, Tohoku University Graduate School of Dentistry , Sendai, Japan
2. Tohoku University Hospital, Head and Neck Cancer Centre , Sendai, Japan
3. Department of Diagnostic Radiology, Tohoku University Hospital , Sendai, Japan
4. Department of Otolaryngology-Head and Neck Surgery, Tohoku University Hospital , Sendai, Japan
Abstract
Objectives
Arrested pneumatisation (AP) is an anatomic variant of the sphenoid sinus. Since AP remains underrecognised, otolaryngologists and radiologists may mistake AP for a lesion and perform follow-up imaging studies. We investigated the imaging findings of CT, MRI, and F-18 fludeoxyglucose (FDG)-positron emission tomography (PET) for AP, and discussed the differences between AP and other skull base lesions.
Methods:
We reviewed multidetector low CT imaging of 442 patients (285 men and 157 women; age range, 19–93 years; mean age, 67.8 years) who underwent FDG-PET/CT for head and neck tumours between January 2019 and December 2019. The imaging findings of AP were reviewed on CT, MRI, FDG-PET/CT, and compared with those of fibrous dysplasia, chordoma, chondrosarcoma, multiple myeloma, and bone invasion of nasopharyngeal carcinoma.
Results
AP was identified in 22 patients (14 men and 8 women; age range, 24–93 years; mean age, 67.0 years) based on criteria from previous reports. AP manifested with well-circumscribed sclerotic margins on CT, without evidence of expansion. AP showed high-signal intensity on T 1-/T 2 weighted MRI. FDG-PET revealed non-significant uptake [maximum standardised uptake value (SUVmax): 0.85 (range, 0.4–1.27)] in AP. Contrastingly, skull base lesions showed expansion, poorly circumscribed boundaries without osteosclerotic margins, and moderate-to-severe FDG uptake (SUVmax: 1.8–8.4).
Conclusions:
The characteristic imaging findings of AP, namely non-expansile on CT and non-uptake on FDG-PET, may aid in its differentiation from other skull base lesions.
Publisher
Oxford University Press (OUP)
Subject
General Dentistry,Radiology, Nuclear Medicine and imaging,General Medicine,Otorhinolaryngology