The value of differential diagnosis between inverted papilloma and hemorrhagic necrotic nasal polyps in nasal cavity and sinus by HRCT and MRI

LI Yimin; ZHAN Alai; HUANG Qingwen

Abstract：Objective To inverstigate the value of differential diagnosis between inverted papilloma and hemorrhagic necrotic nasal polyps in nasal cavity and sinus by HRCT and MRI .Methods General information , clinical manifestation , HRCT and MRI findings of 54 patients with inverted papilloma and 22 patients with hemorrhagic necrotic nasal polyp confirmed by surgically and pathologically were analyzed retrospectively .Results The onset age of hemorrhagic necrotic nasal polyps was younger than inverted papilloma ( P <0.05).Hemorrhagic necrotic nasal polyps showed extensive growth in mode of growth , and inverted papilloma without this feature .Local bone destruction surrounding lesions was an important characteristic for malignant transforma -tion of inverted papilloma .On noncontrast CT scan , the density of hemorrhagic necrotic nasal polyps was higher than inverted pap -illoma ( P <0.05).On contrast-enhanced CT, hemorrhagic necrotic nasal polyps showed progressive enhancement , and inverted papilloma showed strengthening peak appeared in nephrographic phase , then enhanced degree was reduced in delayed phase .On MRI scan, bleeding component in hemorrhagic necrotic nasal polyps appeared hyperintense in T 1 WI and hypointense in T 2 WI.On contrast-enhanced MR , hemorrhagic necrotic nasal polyps showed nodular enhancement and inverted papilloma showed relative ho -mogenous enhancement .Conclusion Inverted papilloma and hemorrhagic necrotic nasal polyps were demonstrated a certain dis -tinction on imaging findings , contrast-enhanced HRCT and MRI scanning have great value in differential diagnosis .