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Melanoma of the Sinonasal Tract: Value of a Septate Pattern on Precontrast T1-Weighted MR Imaging

Authors
 Y.-K. Kim  ;  J.W. Choi  ;  H.-J. Kim  ;  H.Y. Kim  ;  G.M. Park  ;  Y.-H. Ko  ;  J. Cha  ;  S.T. Kim 
Citation
 AMERICAN JOURNAL OF NEURORADIOLOGY, Vol.39(4) : 762-767, 2018 
Journal Title
 AMERICAN JOURNAL OF NEURORADIOLOGY 
ISSN
 0195-6108 
Issue Date
2018
MeSH
Adult ; Aged ; Female ; Humans ; Magnetic Resonance Imaging/methods* ; Male ; Melanoma/diagnostic imaging* ; Melanoma/pathology ; Middle Aged ; Nose Neoplasms/diagnostic imaging* ; Nose Neoplasms/pathology ; Paranasal Sinuses/diagnostic imaging* ; Paranasal Sinuses/pathology ; Retrospective Studies ; Sensitivity and Specificity
Abstract
BACKGROUND AND PURPOSE: Various tumors of the sinonasal tract can exhibit high signal intensity on T1WI. The purpose of this study was to determine the value of a septate pattern on precontrast T1WI for diagnosing sinonasal melanoma. MATERIALS AND METHODS: Retrospectively, 3 observers independently reviewed MR images of 31 histologically proved sinonasal melanomas with special attention to the presence or absence of a septate pattern on precontrast T1WI, defined as alternating hyperintense and hypointense striations on precontrast T1WI. For comparison, we evaluated the prevalence of a septate pattern on precontrast T1WI in 106 nonmelanomatous sinonasal malignant tumors with 16 different histologic types. We also tried to identify the histopathologic features responsible for the septate pattern on precontrast T1WI. RESULTS: Twenty-seven (87.1%) of 31 sinonasal melanomas showed hyperintense foci on T1WI, among which a septate pattern on precontrast T1WI was seen in 23 (74.2%), while 22 (20.8%) of 106 nonmelanomatous malignant tumors demonstrated hyperintense foci on T1WI, among which only 3 (2.8%) showed a septate pattern on precontrast T1WI. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of a septate pattern on precontrast T1WI for the diagnosis of sinonasal melanoma were 74%, 97%, 88%, 93%, and 92%, respectively. Although limited due to the retrospective nature, 4 of 23 histologically reviewed sinonasal melanomas revealed an uneven distribution of melanin with alternating melanin and fibrous bands within the tumors. CONCLUSIONS: A septate pattern on precontrast T1WI might be an adjunctive imaging finding for the diagnosis of sinonasal melanoma. This might be attributed histologically to an uneven distribution of melanin and hemorrhage within the tumors.
Files in This Item:
T201806197.pdf Download
DOI
10.3174/ajnr.A5539
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Cha, Jihoon(차지훈)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/173004
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