Radiologic Differentiation between Granulomatosis with Polyangiitis and Its Mimics Involving the Skull Base in Humans Using High-Resolution Magnetic Resonance Imaging

Granulomatosis with polyangiitis (GPA) can involve the skull base or the Eustachian tubes. GPA is diagnosed on the basis of clinical manifestations and serological tests, although it is challenging to discriminate GPA from infectious processes driving skull base osteomyelitis (SBO) and malignant pro...

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Autores principales:	Boeun Lee, Yun Jung Bae, Byung Se Choi, Byung Yoon Choi, Se Jin Cho, Hyojin Kim, Jae Hyoung Kim
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	granulomatosis with polyangiitis skull base osteomyelitis nasopharyngeal carcinoma magnetic resonance imaging Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/4117069d286b410798b9135eb9c23738
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spelling	oai:doaj.org-article:4117069d286b410798b9135eb9c237382021-11-25T17:22:10ZRadiologic Differentiation between Granulomatosis with Polyangiitis and Its Mimics Involving the Skull Base in Humans Using High-Resolution Magnetic Resonance Imaging10.3390/diagnostics111121622075-4418https://doaj.org/article/4117069d286b410798b9135eb9c237382021-11-01T00:00:00Zhttps://www.mdpi.com/2075-4418/11/11/2162https://doaj.org/toc/2075-4418Granulomatosis with polyangiitis (GPA) can involve the skull base or the Eustachian tubes. GPA is diagnosed on the basis of clinical manifestations and serological tests, although it is challenging to discriminate GPA from infectious processes driving skull base osteomyelitis (SBO) and malignant processes such as nasopharyngeal carcinoma (NPC). Moreover, current serological tests have a low sensitivity and cannot distinguish GPA from these other conditions. We hypothesized that certain MRI characteristics would differ significantly among conditions and aimed to evaluate whether the features could differentiate between GPA, SBO, and NPC involving the skull base. We retrospectively evaluated the MRI findings of patients with GPA, SBO, and NPC. We performed univariable logistic regression analyses to identify the predictive variables for differentiating between conditions and evaluated their diagnostic values. We showed, for the first time, that certain MRI findings significantly differed between patients with GPA and those with SBO or NPC, including the lesion morphology and extent, the apparent diffusion coefficient (ADC) values, the contrast enhancement patterns, the presence or absence of necrosis, and retropharyngeal lymphadenopathy. In conclusion, utilizing certain MRI features can improve the diagnostic performance of MRI by differentiating GPA with skull base involvement from other conditions with similar radiologic findings, including SBO and NPC, facilitating treatment plans and, thus, improving patient outcomes.Boeun LeeYun Jung BaeByung Se ChoiByung Yoon ChoiSe Jin ChoHyojin KimJae Hyoung KimMDPI AGarticlegranulomatosis with polyangiitisskull base osteomyelitisnasopharyngeal carcinomamagnetic resonance imagingMedicine (General)R5-920ENDiagnostics, Vol 11, Iss 2162, p 2162 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	granulomatosis with polyangiitis skull base osteomyelitis nasopharyngeal carcinoma magnetic resonance imaging Medicine (General) R5-920
spellingShingle	granulomatosis with polyangiitis skull base osteomyelitis nasopharyngeal carcinoma magnetic resonance imaging Medicine (General) R5-920 Boeun Lee Yun Jung Bae Byung Se Choi Byung Yoon Choi Se Jin Cho Hyojin Kim Jae Hyoung Kim Radiologic Differentiation between Granulomatosis with Polyangiitis and Its Mimics Involving the Skull Base in Humans Using High-Resolution Magnetic Resonance Imaging
description	Granulomatosis with polyangiitis (GPA) can involve the skull base or the Eustachian tubes. GPA is diagnosed on the basis of clinical manifestations and serological tests, although it is challenging to discriminate GPA from infectious processes driving skull base osteomyelitis (SBO) and malignant processes such as nasopharyngeal carcinoma (NPC). Moreover, current serological tests have a low sensitivity and cannot distinguish GPA from these other conditions. We hypothesized that certain MRI characteristics would differ significantly among conditions and aimed to evaluate whether the features could differentiate between GPA, SBO, and NPC involving the skull base. We retrospectively evaluated the MRI findings of patients with GPA, SBO, and NPC. We performed univariable logistic regression analyses to identify the predictive variables for differentiating between conditions and evaluated their diagnostic values. We showed, for the first time, that certain MRI findings significantly differed between patients with GPA and those with SBO or NPC, including the lesion morphology and extent, the apparent diffusion coefficient (ADC) values, the contrast enhancement patterns, the presence or absence of necrosis, and retropharyngeal lymphadenopathy. In conclusion, utilizing certain MRI features can improve the diagnostic performance of MRI by differentiating GPA with skull base involvement from other conditions with similar radiologic findings, including SBO and NPC, facilitating treatment plans and, thus, improving patient outcomes.
format	article
author	Boeun Lee Yun Jung Bae Byung Se Choi Byung Yoon Choi Se Jin Cho Hyojin Kim Jae Hyoung Kim
author_facet	Boeun Lee Yun Jung Bae Byung Se Choi Byung Yoon Choi Se Jin Cho Hyojin Kim Jae Hyoung Kim
author_sort	Boeun Lee
title	Radiologic Differentiation between Granulomatosis with Polyangiitis and Its Mimics Involving the Skull Base in Humans Using High-Resolution Magnetic Resonance Imaging
title_short	Radiologic Differentiation between Granulomatosis with Polyangiitis and Its Mimics Involving the Skull Base in Humans Using High-Resolution Magnetic Resonance Imaging
title_full	Radiologic Differentiation between Granulomatosis with Polyangiitis and Its Mimics Involving the Skull Base in Humans Using High-Resolution Magnetic Resonance Imaging
title_fullStr	Radiologic Differentiation between Granulomatosis with Polyangiitis and Its Mimics Involving the Skull Base in Humans Using High-Resolution Magnetic Resonance Imaging
title_full_unstemmed	Radiologic Differentiation between Granulomatosis with Polyangiitis and Its Mimics Involving the Skull Base in Humans Using High-Resolution Magnetic Resonance Imaging
title_sort	radiologic differentiation between granulomatosis with polyangiitis and its mimics involving the skull base in humans using high-resolution magnetic resonance imaging
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/4117069d286b410798b9135eb9c23738
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_version_	1718412466229084160

Radiologic Differentiation between Granulomatosis with Polyangiitis and Its Mimics Involving the Skull Base in Humans Using High-Resolution Magnetic Resonance Imaging

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