Abstract

Objective To identify the value of multiparametric MR imaging features including diffusion weighted (DW) and dynamic contrast-enhanced (DCE) MR imaging features in differentiation between inverted papilloma and malignant transformation of inverted papilloma in the sinonasal region. Methods Seventy-seven patients were included in this study, including 12 malignant transformation of inverted papilloma and 65 inverted papillomas. Conventional MRI including nonenhanced and static contrast-enhanced imaging, DCE-and the DW-MRI were analyzed. Differences in conventional MRI features, ADCs and DCE-MRI parameters between the two entities were determined by Fisher exact test, independent samples t-test and Mann-Whitney U test, respectively. Results There were significant differences in convoluted cerebriform pattern (P=0.045), necrosis (P=0.003) and orbit involvement (P<0.01) between inverted papilloma and malignant transformation of inverted papilloma in the sinonasal region. The ADCs of inverted papilloma were significantly lower than those of malignant transformation of inverted papilloma (P<0.01). There were significant differences in time to peak enhancement (P<0.01), maximum contrast index (P=0.004) and time intensity curve types (P<0.01) between the two entities. Conclusions A multiparametric approach using conventional MR imaging with added ADCs and DCE-MRI parameters had the potential to improve the differentiation between inverted papilloma and malignant transformation of inverted papilloma in the sinonasal region. Key words: Nasal cavity; Sinus; Neoplasms; Multiparametric MR imaging

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