Abstract：
OBJECTIVE: This study aimed to examine the characteristics of nasal and imaging findings of sinonasal lesions in granulomatosis with polyangiitis (GPA) patients and how these lesions change over time in both the active and remission phases of the disease.
METHODS: We retrospectively reviewed GPA patients with sinonasal lesions who were followed up at our department between January 2005 and December 2020. The following data were collected: age, sex, symptoms at initial presentation, anti-neutrophil cytoplasmic antibody (ANCA) type, and histopathological, nasal (initial and follow-up), and imaging (initial and follow-up) findings.
RESULTS: This study included 17 patients with GPA aged 30 to 79 years. Computed tomography (CT) of the sinuses showed mucosal thickening in 16 patients, bone thickening in 12, bone destruction in 4, and an orbital invasion mass in 3 at the time of diagnosis. After initiating treatment, mucosal thickening of the sinuses improved in 3 of 16 patients and remained unchanged in 13. Bone thickening at the time of diagnosis remained unchanged in 10 of 12 patients and worsened in 2; 1 patient displayed newly developed bone thickening. Destructive nasal findings on CT were positive for proteinase 3-ANCA.
CONCLUSIONS: Our study revealed that mucosal thickening, bone thickening, bone destruction, and orbital invasion mass were major CT findings in patients with GPA. Intranasal findings such as granulations, crusting, and necrosis were seen in the active phase; moreover, saddle nose, loss of turbinate, and nasal septal perforation were subsequently seen in the course of the disease. Sinonasal findings of GPA vary depending on the disease stage and period.
METHODS: We retrospectively reviewed GPA patients with sinonasal lesions who were followed up at our department between January 2005 and December 2020. The following data were collected: age, sex, symptoms at initial presentation, anti-neutrophil cytoplasmic antibody (ANCA) type, and histopathological, nasal (initial and follow-up), and imaging (initial and follow-up) findings.
RESULTS: This study included 17 patients with GPA aged 30 to 79 years. Computed tomography (CT) of the sinuses showed mucosal thickening in 16 patients, bone thickening in 12, bone destruction in 4, and an orbital invasion mass in 3 at the time of diagnosis. After initiating treatment, mucosal thickening of the sinuses improved in 3 of 16 patients and remained unchanged in 13. Bone thickening at the time of diagnosis remained unchanged in 10 of 12 patients and worsened in 2; 1 patient displayed newly developed bone thickening. Destructive nasal findings on CT were positive for proteinase 3-ANCA.
CONCLUSIONS: Our study revealed that mucosal thickening, bone thickening, bone destruction, and orbital invasion mass were major CT findings in patients with GPA. Intranasal findings such as granulations, crusting, and necrosis were seen in the active phase; moreover, saddle nose, loss of turbinate, and nasal septal perforation were subsequently seen in the course of the disease. Sinonasal findings of GPA vary depending on the disease stage and period.
摘要：
目的：本研究旨在研究肉芽肿性多血管炎（GPA）患者鼻窦病变的鼻部特征和影像学表现，以及这些病变在疾病的活动期和缓解期如何随时间变化。
方法：我们回顾性分析了2005年1月至2020年12月在我科随访的有鼻窦病变的GPA患者。收集了以下数据：年龄，性别,最初出现时的症状，抗中性粒细胞胞浆抗体（ANCA）型，和组织病理学，鼻部（初始和随访），和影像学（初始和随访）发现。
结果：本研究纳入17例GPA患者，年龄30~79岁。鼻窦的计算机断层扫描（CT）显示16例患者的粘膜增厚，诊断时，骨增厚12例，骨破坏4例，眼眶浸润3例。开始治疗后，16例患者中3例的鼻窦粘膜增厚得到改善,13例无变化.诊断时的骨增厚在12例患者中有10例保持不变，在2例中恶化；1例患者显示新发展的骨增厚。CT上的破坏性鼻腔发现为蛋白酶3-ANCA阳性。
结论：我们的研究表明，粘膜增厚，骨增厚,骨破坏,和眼眶侵犯肿块是GPA患者的主要CT表现。鼻内发现，如颗粒，结壳,在活动期见坏死；此外，马鞍鼻子，失去鼻甲，和鼻中隔穿孔随后在疾病的过程中看到。GPA的鼻窦发现因疾病阶段和时期而异。
方法：我们回顾性分析了2005年1月至2020年12月在我科随访的有鼻窦病变的GPA患者。收集了以下数据：年龄，性别,最初出现时的症状，抗中性粒细胞胞浆抗体（ANCA）型，和组织病理学，鼻部（初始和随访），和影像学（初始和随访）发现。
结果：本研究纳入17例GPA患者，年龄30~79岁。鼻窦的计算机断层扫描（CT）显示16例患者的粘膜增厚，诊断时，骨增厚12例，骨破坏4例，眼眶浸润3例。开始治疗后，16例患者中3例的鼻窦粘膜增厚得到改善,13例无变化.诊断时的骨增厚在12例患者中有10例保持不变，在2例中恶化；1例患者显示新发展的骨增厚。CT上的破坏性鼻腔发现为蛋白酶3-ANCA阳性。
结论：我们的研究表明，粘膜增厚，骨增厚,骨破坏,和眼眶侵犯肿块是GPA患者的主要CT表现。鼻内发现，如颗粒，结壳,在活动期见坏死；此外，马鞍鼻子，失去鼻甲，和鼻中隔穿孔随后在疾病的过程中看到。GPA的鼻窦发现因疾病阶段和时期而异。
