鼻腔及鼻窦内翻乳头状瘤的影像学分析  

Imaging Finding of Sinonasal Inverted Papilloma

作　　者：陈小丽 刘建滨[2] 毛志群[2] 张青松 

机构地区：[1]株洲市二医院放射科,湖南株洲412005 [2]湖南省人民医院放射科,长沙410005

出　　处：《实用临床医学（江西）》2012年第5期73-75,F0004,共4页Practical Clinical Medicine

摘　　要：目的探讨鼻腔及鼻窦内翻乳头状瘤的CT及MRI影像学表现,提高对该病的认识及诊断率。方法对27例经手术病理证实的鼻腔及鼻窦内翻乳头状瘤患者的影像学资料进行回顾性分析。结果 27例患者CT均表现为鼻腔或鼻窦软组织密度灶,2例CT增强扫描显示软组织肿块中度强化,2例在MRI T1、T2序列上信号与脑灰质接近,中度强化。其中25例为单侧发病(左侧13例,右侧12例),2例累及双侧。1例仅表现为左侧鼻前庭小息肉样结节;累及中鼻甲区域26例,其中8例累及上颌窦,累及筛窦、鼻咽部各4例。该组中9例见筛骨骨质硬化;5例癌变者均发现筛孔状溶骨性破坏,其中2例累及颅底。结论内翻乳头状瘤好发于单侧中鼻甲区域,具有一定的影像学特征,当发现溶骨性破坏时提示内翻乳头状瘤恶变。MRI对内翻状乳头状瘤软组织边界的显示较CT清晰。Objective To investigate CT and MRI findings of sinonasal inverted papilloma so as to improve the awareness and diagnosis of the disease.Methods Imaging data from 27 patients with pathologically confirmed sinonasal inverted papilloma were analyzed retrospectively.Results CT images showed soft tissue density lesions in all 27 patients.CT contrast enhanced scan showed moderate enhancement of soft tissue mass in 2 cases.MRI scan showed moderate enhancement and image signal was closed to cerebral gray matter using T1-and T2-weighted sequences in 2 cases.Twenty-five patients had unilateral disease（13 patients with left disease and 12 patients right disease）,and 2 patients had bilateral disease.One case showed only a small polypoid nodule in the left side of nasal vestibule,and another 26 cases had violation in middle turbinate region（8 cases involving the maxillary sinus,4 cases involving the ethmoid sinus and 4 cases involving the nasopharynx）.In addition,9 patients showed ethmoid bone sclerosis,and 5 patients showed cribriform osteolytic destruction（2 cases involving the skull base）.Conclusion Inverted papilloma often occurs in one side of the middle turbinate region with a certain image feature and byosteolytic destruction means malignant transformation.MRI is superior to CT for displaying the boundaries of inverted papilloma.

关 键 词：内翻乳头状瘤 鼻腔 鼻窦疾病 CT MRI 

分 类 号：R739.62[医药卫生—肿瘤]