颅外原发性病变破坏颅中窝底的CT表现  

CT evaluation of the primary extracranial neoplastic diseases eroding the central skull base

作　　者：余强[1] 王平仲[1] 石慧敏[1] 罗济程[1] 

机构地区：[1]上海第二医科大学口腔医学院

出　　处：《中华口腔医学杂志》1999年第3期139-141,共3页Chinese Journal of Stomatology

摘　　要：目的评价颅外原发性病变破坏颅中窝底的ＣＴ表现特点。方法将４９例经病理证实的破坏颅中窝底的颅外原发病变分为两组：颅中窝底原发骨性病变（Ⅰ组）：１０例；颌面部原发病变（Ⅱ组）：３９例。结果颅外病变破坏颅中窝底的方式有４种：①骨吸收（３０例），包括１６例颅中窝底外板吸收和１４例内外板均吸收；②颅中窝底硬化增厚（４例）；③圆孔和卵圆孔扩大（９例）；④硬化和吸收并存（６例）。受累的颅内结构：海绵窦１２例，颞叶１１例和脑垂体２例。受侵的颅中窝底结构有：蝶骨大翼３４例，蝶骨体２２例，蝶骨翼突２３例，颞骨岩部１５例和颞骨关节面８例。结论颅中窝底原发骨病变的ＣＴ表现具有多样性。颌面原发病变破坏颅中窝底以骨吸收为主，且多通过颌面深部间隙（颞下、翼腭和咽旁间隙）侵犯蝶骨大翼。Objective To evaluate the central skull base erosion caused by primary extracranial mass lesions with CT. Methods Fortynine patients (33 males and 16 females; mean, 40.2 years) suffered from the primary extracranial neoplastic diseases with middle skull base involvement were divided into two groups: group (10 cases), primary osseous lesions of the central skull base and group (39 cases), primary maxillofacial neoplasms. All lesions were confirmed histopathologiclly by surgery and biopsy. Results Four invasion patterns of the central skull base were identified on CT: I. resorption of the cortical bone (30 cases), including outer cortical margin destruction in 16 cases (group II lesions) and both inner and outer laminae resorption in 14 cases (4 group I lesions and 10 groups II lesions). II. ossification and thickening of the skull base (4 group I cases, all were fibrous dysplasia) III. erosive enlargement of the ovale and rotundam foramina (9 group II cases). IV. combined sclerosis and resorption of the skull base (6 cases, 2 group I lesions and 4 group II lesions).Involvement of the intracranial structures embraced the cavernous sinus (n=12; group II lesions), temporal lobe (n=11; 5 group I lesions and 6 group II lesions), and pituitary (n=2, group II lesions). CT demonstrated the following central skull base structures were eroded: greater wing of sphenoid bone (n=34), sphenoid body (n=22), sphenoid process (n=23), petrous bone (n=15), and articular fossa of the temporal bone (n=8). Conclusion Osseous lesions originating from the central skull base have various CT manifestations. The cortical resorption of the central skull base may be regarded as a main pattern of bone erosion caused by primary maxillofacial neoplasms, and most of them have lesions involve the greater wing of sphenoid bone t

关 键 词：头颈部肿瘤 CT 诊断 颅外原发性病变 

分 类 号：R739.91[医药卫生—肿瘤]