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Case No. 340
2014-06-01~2014-06-30
출제자 : 최승홍
Hit : 353
| Period | 2014-06-01~2014-06-30 |
|---|---|
| Diagnosis | Petrous apex cholesterol granuloma |
| Clinical information | M/61 우연히 발견 진단은? |
| Discussion | Terminology Expansile petrous apex lesion resulting from foreign body giant cell reaction to deposition of cholesterol crystals in apical air cells, with fibrosis & vascular proliferation Imaging Temporal bone CT findings Sharply marginated, expansile PA lesion Trabecular breakdown with cortical thinning of PA expected Larger lesions will have areas of focal bony wall dehiscence MR findings High T1 internal signal, High T2 internal signal.Peripheral low signal hemosiderin ring (T2) Differential diagnosis - Petrous Apex Congenital Cholesteatoma CT: Smooth, expansile margins T1 MR: Low to intermediate signal; T2 MR: Intermediate to high signal DWI: Restricted diffusion (high signal) - Petrous Apex ICA Aneurysm CT: Smooth expansion of petrous ICA canal MR: Heterogeneous signal with internal flow void T1 C+ MR: Heterogeneous internal enhancement - Petrous Apex Mucocele CT: Single, expansile air cell area in PA MR: Low T1, high T2, nonrestricted DWI Reference> Head and neck, Hansberger et al, Amirsys, 2009 |
| Correct answer |
Correct Answer
Semi-Correct Answer |