Fig. 3
A 65-year-old female with bilateral nasal obstruction and epistaxis. Axial T2-weighted image (a) reveals bilateral bi-nasal inverted papillomas, showing linear divergent and multi-directional sclerosis. Axial diffusion and apparent diffusion co-efficient maps (a) and (b) reveal an apparent diffusion co-efficient of 1.5 × 10-3 cm2/s. Axial post-gadolinium-enhanced image (d) reveals striations less conspicuous than T2 images. Axial computed tomography image reveals smooth mass effect with linear sclerosis at turbinate wall, where striations are divergent in relation to the site of focal hyperostosis. Coronal computed tomography image (f) shows the nasal lesions to have considerable intra-antral extensions through widened ostio-meatal units and through rarefied medial wall, as well as through widened post-meatal accessory ostia