【医学影像每日一例】蝶窦病变

病例来源：American College of RadiologyCase Authors：Marco Marangoni, MD; Gabriela Abrego, MD; Bruce Curt Gilbert, MD【简要病史】72岁女性，进行性水平及垂直方向复视，进展迅速，伴有右侧前额、鼻部疼痛。Question1.Which of the following are present on these images? (Check all that apply.)此组图像的可见下列那种表现？（选择全部正确选项）Orbital apex involvement眶尖部侵犯Osseous sclerosis骨质硬化Mastoid air cell destruction乳突气房破坏Sphenoid sinuscortical disruption蝶窦皮质破坏正确选项：1、3、4注释：此病变累及蝶窦外侧壁，侵入右侧眶尖，表现为此处正常脂肪消失。双侧蝶窦壁及间隔增厚、硬化，蝶窦浑浊。所示图像并无证据表明乳突气房破坏。可见右侧蝶窦外侧壁局部骨皮质破坏。Question2. Brain MRimages demonstrate ………………………………