Juvenile Nasopharyngeal Angiofibroma

Prof. Dr. Safdar Ali MalikHOD Radiology Deptt. SIMS/SHL

DR. Muhammad Bin ZulfiqarPGR II New Radiology Deptt. SIMS/SHL

Plain Radiography Non specific Opacification of Right

nasal cavity. Haziness of right maxillary

sinus. Haziness of anterior

ethmoid cells more marked on right side.

Partial opacification of right frontal sinus.

CT Imaging NECT shows soft tissue

density lesion in nasal cavity with main stem in sphenopalatine foramen.

Laterally extending into pterygopalatine fossa and through it into infratemporal fossa

Extending into sphenoid sinuses with erosion

Extending into rt. Maxillary sinus

Both ethmoid sinuses with ballooning.

Right frontal sinus Orbital cavity.

Intense contrast enhancement suggest highly vascular tumor.

MR IMAGINGT1 Images

MR have better tissue contrast and resolution . In this case advised to sort out blindness.

T1 images show intermediate signal of lesions with flow voids.

Additional finding are soft tissue intensification of right orbit.

Extraxial intracranial extension.

TI GAD Intense

Enhancement.

T2 ImagesT2 IMAGES SHOW HYPERINTENSE LESION

WITH FLOW VOID.

MR AngiographyBranch comes from External carotid artery

which is Internal maxillary artery as evidence by Z stepping of angiofibroma.

Conventional AngiographyAngiography shows the

primary feeders of the lesion coming from the right external carotid artery which is internal maxillary artery.

Now performed only for selective cases who are candidate of preoperative embolization.

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