This document discusses the radiological findings of a patient. Plain radiography showed opacification and haziness in the right nasal cavity, maxillary sinus, ethmoid cells, and frontal sinus. CT imaging revealed a soft tissue density lesion in the nasal cavity extending into surrounding areas with erosion and contrast enhancement, suggesting a highly vascular tumor. MRI showed intermediate signal of the lesions on T1 images with additional soft tissue in the right orbit and extraaxial intracranial extension. T1 post-contrast images showed intense enhancement. MR angiography and conventional angiography identified the primary feeders of the lesion coming from the right external carotid artery.

1. Prof. Dr. Safdar Ali Malik
HOD Radiology Deptt. SIMS/SHL
DR. Muhammad Bin Zulfiqar
PGR II New Radiology Deptt. SIMS/SHL

2. 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.

4. 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.

5.  Intense contrast
enhancement suggest
highly vascular tumor.

6. MR IMAGING
T1 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.

7. TI GAD
 Intense Enhancement.

8. T2 Images
 T2 IMAGES SHOW HYPERINTENSE LESION WITH
FLOW VOID.

9. MR Angiography
 Branch comes from External carotid artery which is
Internal maxillary artery as evidence by Z stepping of
angiofibroma.

10. Conventional Angiography
 Angiography 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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