Premium
Early Postoperative Magnetic Resonance in the Diagnosis of Persistent Juvenile Angiofibroma
Author(s) -
Schreiber Alberto,
Ravanelli Marco,
Ferrari Marco,
Mattavelli Davide,
Rampinelli Vittorio,
Bolzoni Villaret Andrea,
Bertazzoni Giacomo,
Tomasoni Michele,
Gualtieri Tommaso,
Zorza Ivan,
Farina Davide,
Maroldi Roberto,
Nicolai Piero
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.29293
Subject(s) - magnetic resonance imaging , medicine , radiology , angiofibroma , otorhinolaryngology , flow chart , juvenile nasopharyngeal angiofibroma , surgery , engineering drawing , engineering
Objectives/Hypothesis Despite improvements in the treatment of juvenile angiofibroma (JA), the rate of persistence (pJA) is still not negligible. In the present study, we assessed the value of early postoperative magnetic resonance imaging (MRI) in depicting unintentional pJAs and designed a MRI‐driven decisional flow‐chart for pJA management and follow‐up. Study Design Observational study. Methods Patients undergoing early postoperative MRI after endoscopic resection of JA in the Unit of Otorhinolaryngology – ASST Spedali Civili, University of Brescia from 2007 to 2017 were enrolled. MRI was defined as negative or positive based on defined radiological criteria. The diagnostic performance of MRI was evaluated. Results The analysis included 26 patients, with a mean age of 16.5 years (range, 11–25). Early MRI was negative for pJA in 21 (80.8%) patients and positive in five (19.2%). No patient with a negative finding was found positive at subsequent follow‐up MRIs. The accuracy of a positive finding was confirmed by pathologic examination (three cases) or follow‐up MRIs (two cases). The diagnostic performance of MRI was excellent with sensitivity and specificity of 100%. An MRI‐driven flow‐chart for pJA management and follow‐up was designed. Conclusions Early postoperative MRI demonstrated a high diagnostic accuracy in the detection of unintentional pJA. Our MRI‐driven strategy and decisional flow‐chart could aid in the decision‐making process in the management of pJA and definition of postoperative surveillance. Level of evidence 4 Laryngoscope , 131:E2436–E2441, 2021