嗅神经母细胞瘤的CT和MRI诊断  

The CT and MRI Diagnosis of Esthesioneuroblastoma

作　　者：吴元魁[1] 许乙凯[1] 陈卫国[1] 杨慧[1] 贾铭[1] 刘国清[1] 

机构地区：[1]广州南方医科大学南方医院影像中心,510515

出　　处：《临床放射学杂志》2007年第10期981-984,共4页Journal of Clinical Radiology

摘　　要：目的评价CT和MRI在嗅神经母细胞瘤的诊断、分期和在临床随访中的价值。资料与方法回顾性分析12例经病理证实的嗅神经母细胞瘤的CT和MRI表现,包括肿瘤部位和大小、累及范围、骨破坏、出血和坏死以及密度和信号改变等。CT平扫4例,增强扫描3例。MRI为SET1WI和T2WI,MRI平扫10例,Gd-DTPA增强扫描9例。3例有随访CT,7例有随访MRI。结果(1)肿瘤分期:按Kadish分期标准,A期0例,B期1例,C期11例,2例伴颈部淋巴结转移。(2)信号和密度改变:MRI平扫信号均匀者6例,T1WI呈低信号,T2WI呈稍高信号;信号不均匀者4例,肿瘤内可见出血和坏死区。增强扫描9例,3例为中度不均匀强化,5例为明显不均匀强化,1例为明显均匀强化。CT平扫示肿瘤密度较均匀,与肌肉接近,增强扫描2例呈中度均匀强化,1例呈明显不均匀强化。(3)沟通瘤:肿瘤同时累及颅内外者7例,双侧额叶同时受累2例,右侧额叶受累1例,左额叶受累1例,双侧额叶及左侧岛叶、基底核同时受累2例,仅累及硬脑膜者1例。脑组织水肿6例。(4)临床随访9例,影像学检查见肿物消失3例,缩小5例,术后复发1例。结论嗅神经母细胞瘤的影像学表现无特异性。检查目的为界定肿瘤累及范围。定期影像学随访有助于及时检出复发和及时行补救治疗。Objective To assess the role of CT and MRI in the diagnosis, staging and follow up of esthesioneuroblastoma. Materials and Methods The CT and MRI findings of 12 cases with esthesioneuroblastoma proven histologically were reviewed retrospectively. The site, size and extent of tumor, bone destruction and hemorrhage, necrosis, signal intensity or density changes were analyzed. CT scans were done in 4 cases, 3 had enhanced CT. MRI was done in 9 cases with SE T1WI and T2WI, and enhanced T1WI was obtained in 9 cases. Follow up imaging was performed in 10 cases （CT in 3 cases, MRI in 7 cases）. Results （1）Staging： According to Kadish staging, there were 0 case with stage A, 1 with stage B and 11 with stage C, accompanied with cervical lymph node metastasis in 2 cases. （2）Signal intensity and density changes： On MRI plain scan, tumor signal intensity was homogeneous in 6 cases with hypointensity on T1WI and moderate hyperintensity on T2 WI, and tumor signal intensity was heterogeneous in 4 cases with hemorrhage and necrosis. In the 9 cases of enhanced MRI, the tumors were moderately and heterogeneously enhanced in 3 cases, heterogeneously remarkably enhanced in 5 cases and homogeneously marked enhanced in 1 case. The tissue density on plain CT was equal to that of muscle and relatively homogeneous. The tumors showed moderate and homogeneous enhancement in 2 cases and heterogeneous and remarkable enhancement in 1 case on enhanced CT. （3）Intracranial and extracranial tumor： 7 cases with intracranial extension, bilateral frontal lobe involvement in 2 cases, right and left frontal lobe invovlement in 1 and 2 cases respectively, bilateral frontal lobes, left insula lobe and basal nuclei involvement in 2 cases, and cerebral dural mater involved solely in 1 case. The brain tissue edema occurred in 6 cases. （4）9 cases had clinic follow up, and showed tumor vanished, decreasing in size and recurrence in 3 cases, 5 cases and 1 case respectively. Conclusion The imaging findings of olfactory neuroblastoma ar

关 键 词：嗅神经母细胞瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R739.4[医药卫生—肿瘤]