鼻与鼻副窦恶性肿瘤的CT诊断(附90例报告)  

CT Diagnosis of Malignant Tumors of the Nasal and Paranasal Sinuses

作　　者：袁赟[1] 时建[1] 王少新[2] 

机构地区：[1]四川省建筑医院放射科,成都610081 [2]四川省肿瘤医院头颈科,成都610041

出　　处：《肿瘤预防与治疗》2008年第4期420-422,共3页Journal of Cancer Control And Treatment

摘　　要：目的:探讨鼻和鼻副窦恶性肿瘤CT的诊断意义。方法:回顾性分析90例鼻与鼻副窦恶性肿瘤的CT影像表现。结果:鼻腔鼻副窦癌68例,多为密度不均匀肿块,直接侵犯腔内及腔外结构并形成软组织肿块;65例骨质破坏明显,可见骨壁碎裂、缺失,鼻面部软组织肿胀不常见。T细胞性淋巴瘤10例,多起源于鼻前庭,以混合表现为主,多数密度均匀,主要累及腔内结构,但鼻面部肿胀常见;骨质破坏不明显或轻微,3例可见骨质吸收。嗅神经母细胞瘤2例和纤维肉瘤1例表现与癌肿相似。1例骨肉瘤病灶内可见骨样组织影。6例转移恶性肿瘤的CT主要表现为窦腔内软组织肿块及窦壁骨质破坏,结论:CT能良好显示鼻和鼻副窦恶性肿瘤窦腔内软组织肿块及窦壁骨质破坏,并能显示恶性肿瘤的侵犯范围,区别侵蚀性骨质破坏与骨改建,有利于良、恶性肿瘤的鉴别。肿瘤突破窦壁产生窦外软组织结构的改变,是恶性肿瘤特征性表现,对恶性肿瘤诊断具有重要意义。Objective： To discuss the application of CT diagnosis for the malignant tumors of the nasal and paranasal sinuses. Methods： The CT diagnoses of 90 malignant tumors in nasal and paranasal sinuses were retrospectively analyzed. Results： There were 68 cases of carcinoma located in nasal cavity and paranasal sinuses, most of which presented with inhomogeneous masses. The carcinoma directly invaded the inside and outside of the cavity, and formed the soft tissue masses. In 65 cases, there were obvious bone dest rupture which featured with the rupture or defect of bone chips, but there were no obviously swelling of facial soft tissue. There were 10 cases of T-cell lymphoma and most of which derived from nasalvestibule, and the majority were mixed type with homogeneous density. The structure in the cavity were mainly involved, but the swelling of tissue around noses was not presented, showing no or mild bone dest rupture, and 3 cases presented bony absorption. 2 cases of olfactory neuroblastoma and 1 case of fibrosarcoma had similar appearances with carcinoma. 1 case of osteoid tissue was found in the lesion of osteogenic sarcoma. The CT diagnosis of 6 cases transitional malignant tumors was based on the soft masses in the sinus and the destruction of adjacent bone wall. Condusion： CT scan is apparently superior to plain film for showing these two signs of the soft masses in the sinus and the destruction of adjacent bone wall. CT scan can very nicely reveal the extent invaded by malignant tumors with the difference between aggressive bone destruction and bone remodeling, which helps distinguishing benign tumors with malignant tumors. When tumors develop further and invade the soft tissue outside of sinus, malignant tumors will show their particular characteristics which are significant to their diagnosis.

关 键 词：鼻与鼻副窦 恶性肿瘤 CT诊断 

分 类 号：R739.6[医药卫生—肿瘤]