Sinusitis sphenoidalis

Chronische

Sinusitis sphenoidalis links mit deutlicher Verdickung des umgebenden Knochens als Zeichen des langen entzündlichen Geschehens.

Chronische

Sinusitis der Keilbeinhöhle (Sinusitis sphenoidalis) mit reaktiver Verdickung der umgebenden Knochenlamellen. CT axial im Knochenfenster.

Sphenoid

sinus aspergilloma clinically mimicking as malignancy—a case report. a, b Computed tomography axial and sagittal images without contrast show hyper dense soft tissue in the expanded sphenoid sinus; its pneumatized portion of greater wing of sphenoid bones, clivus, and posterior ethmoid air cells. There is extension of soft tissue at the left orbital apex (blue arrow). Extension of lesion into sella is seen. Plain CT axial (c) and coronal bone window images (d) show completely thinned out and remodeled surrounding bony walls due to pressure necrosis. Complete rarified medial wall of bilateral internal carotid artery canals also seen (yellow arrows). e Post-operative axial bone window CT image shows air filled sinus cavity with absence of soft tissue

Sphenoid

sinus aspergilloma clinically mimicking as malignancy—a case report. a T1-weighted axial MRI image shows hyper intense lesion filling the sphenoid sinus extending into adjacent greater wing of sphenoid bone, posterior ethmoid air cells, and clivus (blue arrow). The lesion appears hypo intense/dark on axial T2-weighted image (b) and sagittal T2-weighted image (c) confirming the proteinaceous content within the sinus. There is extension of lesion into bilateral cavernous sinus with partial encasement of bilateral cavernous segment of internal carotid arteries (red arrows). Sella is not seen completely separate from the lesion (c).

Sphenoid

sinus aspergilloma clinically mimicking as malignancy—a case report. MRI images (a) Lesion appears dark on FLAIR image. Lesion appears dark on diffusion-weighted image (b) and apparent diffusion coefficient (c) confirming no restriction. Post-gadolinium fat sat axial (d) and sagittal (e) image shows no significant enhancement

Chronische

Sinusitis sphenoidalis links mit partiell nur sehr dünne knöcherner Überdeckung an der Clivus Rückseite, sodass bei entzündlicher Permeation nach intrakraniell eine Meningitis droht. Zusätzlich auch dorsale Ethmoidalzellen links verlegt. Beachte auch die Verdickung der knöchernen Begrenzung der Sinus (vergleiche Gegenseite) als Zeichen der ossären Mitreaktion.