PDF(Pubmed)
Abstract：
BACKGROUND: Pretreatment assessment of local extension in sinonasal cancer is essential for prognostic evaluation and surgical planning. The aim of this study was to assess the diagnostic performance of two common imaging techniques (CT and MRI) for the diagnosis of skull base and orbital invasion by comparing imaging findings to histopathological data.
METHODS: This was a retrospective two-center study including patients with sinonasal cancer involving the skull base and/or the orbit operated on between 2000 and 2019. Patients were included only if pre-operative CT and/or MRI, operative and histopathologic reports were available. A double prospective blinded imaging review was conducted according to predefined radiological parameters. Radiologic tumor extension was compared to histopathological reports, which were considered the gold standard. The predictive positive value (PPV) for the diagnosis of skull base/orbital invasion was calculated for each parameter.
RESULTS: A total of 176 patients were included. Ethmoidal intestinal-type adenocarcinoma was the most common type of cancer (41%). The PPV for major modification of the bony skull base was 78% on the CT scan, and 89% on MRI. MRI signs of dural invasion with the highest PPVs were: contact angle over 45° between tumor and dura (86%), irregular deformation of dura adjacent to tumor (87%) and nodular dural enhancement over 2 mm in thickness (87%). Signs of orbital invasion had low PPVs (<50%).
CONCLUSIONS: This retrospective study provides objective data about the diagnostic value of pretreatment imaging in patients with sinonasal cancer.
METHODS: This was a retrospective two-center study including patients with sinonasal cancer involving the skull base and/or the orbit operated on between 2000 and 2019. Patients were included only if pre-operative CT and/or MRI, operative and histopathologic reports were available. A double prospective blinded imaging review was conducted according to predefined radiological parameters. Radiologic tumor extension was compared to histopathological reports, which were considered the gold standard. The predictive positive value (PPV) for the diagnosis of skull base/orbital invasion was calculated for each parameter.
RESULTS: A total of 176 patients were included. Ethmoidal intestinal-type adenocarcinoma was the most common type of cancer (41%). The PPV for major modification of the bony skull base was 78% on the CT scan, and 89% on MRI. MRI signs of dural invasion with the highest PPVs were: contact angle over 45° between tumor and dura (86%), irregular deformation of dura adjacent to tumor (87%) and nodular dural enhancement over 2 mm in thickness (87%). Signs of orbital invasion had low PPVs (<50%).
CONCLUSIONS: This retrospective study provides objective data about the diagnostic value of pretreatment imaging in patients with sinonasal cancer.
摘要：
背景：鼻窦癌局部扩展的治疗前评估对于预后评估和手术计划至关重要。这项研究的目的是通过将影像学发现与组织病理学数据进行比较，来评估两种常见的成像技术（CT和MRI）用于诊断颅底和眼眶侵犯的诊断性能。
方法：这是一项回顾性的两中心研究，包括2000年至2019年间手术的累及颅底和/或眼眶的鼻窦炎患者。患者仅在术前CT和/或MRI检查，有手术和组织病理学报告.根据预定义的放射学参数进行了双前瞻性盲成像审查。将放射学肿瘤扩展与组织病理学报告进行了比较，被认为是黄金标准。计算每个参数诊断颅底/眼眶侵犯的预测阳性值（PPV）。
结果：共纳入176例患者。筛状肠型腺癌是最常见的癌症类型（41％）。在CT扫描中，骨颅底的主要修饰的PPV为78％，核磁共振成像为89%。最高PPV的硬脑膜侵犯的MRI征象是：肿瘤和硬脑膜之间的接触角超过45°（86％），与肿瘤相邻的硬脑膜不规则变形（87％）和厚度超过2mm的结节性硬脑膜增强（87％）。轨道侵入的迹象具有低PPV(<50%)。
结论：这项回顾性研究提供了关于鼻窦癌患者预处理成像诊断价值的客观数据。
方法：这是一项回顾性的两中心研究，包括2000年至2019年间手术的累及颅底和/或眼眶的鼻窦炎患者。患者仅在术前CT和/或MRI检查，有手术和组织病理学报告.根据预定义的放射学参数进行了双前瞻性盲成像审查。将放射学肿瘤扩展与组织病理学报告进行了比较，被认为是黄金标准。计算每个参数诊断颅底/眼眶侵犯的预测阳性值（PPV）。
结果：共纳入176例患者。筛状肠型腺癌是最常见的癌症类型（41％）。在CT扫描中，骨颅底的主要修饰的PPV为78％，核磁共振成像为89%。最高PPV的硬脑膜侵犯的MRI征象是：肿瘤和硬脑膜之间的接触角超过45°（86％），与肿瘤相邻的硬脑膜不规则变形（87％）和厚度超过2mm的结节性硬脑膜增强（87％）。轨道侵入的迹象具有低PPV(<50%)。
结论：这项回顾性研究提供了关于鼻窦癌患者预处理成像诊断价值的客观数据。
