title: Multiparametric MRI findings of sinonasal rhabdomyosarcoma in adults with comparison to carcinoma.
abstract: To identify magnetic resonance imaging (MRI) features of sinonasal rhabdomyosarcoma in adults, including diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) MRI features as compared with carcinomas.
  
  
  
  Sixty-four patients were included in this study, including 12 sinonasal rhabdomyosarcomas and 52 sinonasal carcinomas. MRI was completed in all 64 patients with a 3T MR scanner. Conventional MR (nonenhanced and static contrast-enhanced) imaging features, DCE-MRI parameters, and the apparent diffusion coefficients (ADCs) were analyzed by two authors independently (X.Y.W. and Y.Z.W.).
  
  
  
  Compared with gray matter, sinonasal rhabdomyosarcomas appeared isointense on T1-weighted images in 11 cases (91.7%, 11 of 12), and hyperintense on T2-weighted images in 9 patients (75%, 9 of 12). After contrast, sinonasal rhabdomyosarcomas showed inhomogeneous enhancement in 10 cases (83.3%, 10 of 12). Skull involvement was found in eight patients (66.7%) with rhabdomyosarcomas. On T2-weighted images, sinonasal carcinomas demonstrated isointense in 31 cases (59.6%, 31/52), hyperintense in 14 (26.9%, 14/52), and hypointense in 7 (13.5%, 7/52). Skull involvement was detected in 14 cases (14/52, 26.9%). There were significant differences in T2signal intensity (P = 0.005) and skull involvement (P = 0.016) between sinonasal rhabdomyosarcoma and carcinomas. There was a marginal difference in time to peak enhancement (P = 0.061), while no difference in time to maximum enhancement (P = 0.403), maximum contrast index (P = 0.368), and time-intensity curve types (P = 0.138) between rhabdomyosarcoma and carcinomas. The ADCs of sinonasal rhabdomyosarcoma were significantly lower than those of sinonasal carcinomas (P < 0.001).
  
  
  
  A multiparametric approach using conventional MRI with added ADCs had the potential to improve the diagnostic accuracy of sinonasal rhabdomyosarcoma in adults. Evidence level: 4 J. Magn. Reson. Imaging 2017;45:998-1004.
authors.affiliation: Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
authors.forename: Xinyan
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
authors.forename: Liyuan
authors.initials: L
authors.lastname: Song
authors.affiliation: Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.|Department of Diagnostic Radiology, National University Hospital, National University Health System, Singapore.
authors.forename: Vincent
authors.initials: V
authors.lastname: Chong
authors.affiliation: Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
authors.forename: Yongzhe
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
authors.forename: Junfang
authors.initials: J
authors.lastname: Xian
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000000981:diagnostic imaging*; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012208:Rhabdomyosarcoma / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: adult rhabdomyosarcoma; diffusion-weighted; dynamic contrast-enhanced; magnetic resonance imaging; sinonasal carcinoma