Computed tomography and magnetic resonance imaging findings of nasal cavity hemangiomas according to histological type

Korean J Radiol. 2015 May-Jun;16(3):566-74. doi: 10.3348/kjr.2015.16.3.566. Epub 2015 May 13.

Abstract

Objective: To compare computed tomography (CT) and magnetic resonance imaging (MRI) findings between two histological types of nasal hemangiomas (cavernous hemangioma and capillary or lobular capillary hemangioma).

Materials and methods: CT (n = 20; six pre-contrast; 20 post-enhancement) and MRI (n = 7) images from 23 patients (16 men and seven women; mean age, 43 years; range, 13-73 years) with a pathologically diagnosed nasal cavity hemangioma (17 capillary and lobular capillary hemangiomas and six cavernous hemangiomas) were reviewed, focusing on lesion location, size, origin, contour, enhancement pattern, attenuation or signal intensity (SI), and bony changes.

Results: The 17 capillary and lobular hemangiomas averaged 13 mm (range, 4-37 mm) in size, and most (n = 13) were round. Fourteen capillary hemangiomas had marked or moderate early phase enhancement on CT, which dissipated during the delayed phase. Four capillary hemangiomas on MRI showed marked enhancement. Bony changes were usually not seen on CT or MRI (seen on five cases, 29.4%). Half of the lesions (2/4) had low SI on T1-weighted MRI images and heterogeneously high SI with signal voids on T2-weighted images. The six cavernous hemangiomas were larger than the capillary type (mean, 20.5 mm; range, 10-39 mm) and most had lobulating contours (n = 4), with characteristic enhancement patterns (three centripetal and three multifocal nodular), bony remodeling (n = 4, 66.7%), and mild to moderate heterogeneous enhancement during the early and delayed phases.

Conclusion: CT and MRI findings are different between the two histological types of nasal hemangiomas, particularly in the enhancement pattern and size, which can assist in preoperative diagnosis and planning of surgical tumor excision.

Keywords: CT and MR; Capillary hemangioma; Cavernous hemangioma; Lobular capillary hemangioma; Pyogenic granuloma; Sinonasal hemangioma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Hemangioma, Capillary / diagnostic imaging*
  • Hemangioma, Cavernous / diagnosis
  • Hemangioma, Cavernous / diagnostic imaging*
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Nasal Cavity / diagnostic imaging
  • Paranasal Sinuses / diagnostic imaging*
  • Retrospective Studies
  • Tomography, X-Ray Computed*
  • Young Adult