颞骨肿块的影像学研究  

Imaging investigation of the masses of temporal bone

作　　者：鲜军舫[1] 王振常[1] 梁熙虹[1] 燕飞[1] 曲永惠[1] 郑军[2] 刘中林[1] 赵啸天[2] 张燕明[1] 

机构地区：[1]首都医科大学附属北京同仁医院放射科,北京100730 [2]首都医科大学附属北京同仁医院耳鼻咽喉科,北京100730

出　　处：《中华放射学杂志》2003年第9期819-822,共4页Chinese Journal of Radiology

摘　　要：目的　研究颞骨肿块的CT、MRI和DSA表现及其临床价值。方法　对照分析 2 1例颞骨肿块的CT、MRI和DSA表现与手术病理表现。结果　 5例颈静脉球瘤均显示“椒盐征”和肿瘤明显染色。 3例鼓室球瘤表现为鼓室内明显强化的软组织影和肿瘤明显染色。 4例内淋巴囊肿瘤CT表现为岩骨迷路后前庭水管区和中内耳软组织肿块及骨质破坏 ,MRI表现为“椒盐征” ,T1WI示肿块边缘有环形高信号影 ,DSA示 3例内淋巴囊腺样囊性癌明显染色。 4例外中耳鳞癌CT表现为不规则软组织肿块以及中外耳广泛骨质破坏 ,1例DSA表现有肿瘤染色。 2例软骨肉瘤CT表现为含有点片状钙化的软组织肿瘤 ,1例肿瘤周边可见高密度环。 2例鼻咽癌侵犯中内耳 ,表现为岩部、鼓室、乳突和颈静脉窝不规则肿块和骨质破坏。 1例嗜酸性肉芽肿CT表现为岩部、鼓室不规则肿块和骨质破坏。结论　CT和MRI清楚显示肿块的形态、范围和内部结构 ,能准确定位 ,CT、MRI和DSA结合有助于肿块的定性诊断 。Objective To investigate CT, MRI, and DSA findings of the masses of temporal bone and their clinical values. Methods CT, MRI, and DSA findings of twenty-one patients with the masses of temporal bone were analyzed, and the imaging findings were compared with the operative and pathological findings. Results All five patients with glomus jugulare paraganglioma displayed “salt and pepper” sign and tumoral staining. Marked enhanced mass and tumoral staining were observed in three patients with glomus tympanicum paraganglioma. Soft tissue mass located in the vestibular aqueduct, middle cavity and inner ear, and extensive bony destruction were seen on CT in four cases with papillary endolymphatic sac tumors (ELST). Four cases with ELST showed “salt and pepper” sign and ringlike high signal intensty on T 1WI. Tumoral staining was seen in three patients with ELST. Irregular soft tissue mass and extensive bony destruction of external and middle ear were found in four cases with squamous carcinoma of external and middle ear, and tumoral staining was observed in 1 case. Two cases with chondrosarcoma demonstrated soft tissue masses containing calcification on CT, with a high density ring surrounding the tumor in 1 case. Irregular soft tissue mass of petrous bone, tympanum, mastoid process and jugular fossa, and bony destruction were found in two cases with nasopharyngeal carcinoma invading middle and inner ear. One patient with eosinophilic granuloma showed irregular soft tissue mass of petrous bone and tympanum and bony destruction. Conclusion CT, MRI, and DSA could definitely demonstrate the shape, extent, and characteristics of the temporal bone masses, which may contribute to the diagnosis and treatment.

关 键 词：肿块 肿瘤 颞骨 骨质破坏 MRI 鼓室 DSA表现 显示 边缘 信号 

分 类 号：R445[医药卫生—影像医学与核医学]