鼻咽纤维血管瘤MRI表现及其影像学分期价值  

MR imaging findings and its value of imaging stage of nasopharyngeal angiofibroma

作　　者：闫钟钰[1] 梁熙虹[1] 李静[1] 王振常[1] 

机构地区：[1]首都医科大学附属北京同仁医院影像中心,北京100730

出　　处：《磁共振成像》2012年第5期355-360,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：北京市卫生系统高层次卫生技术人才基金(编号:2011-2-10)

摘　　要：目的探讨鼻咽纤维血管瘤MRI特征及其术前分期价值。材料与方法分析74例鼻咽纤维血管瘤患者MRI信号特点,包括病变部位、轮廓、边缘、信号强度、信号均匀度、流空信号、强化程度;分析患者MRI术前影像学分期,并与临床手术分期对照。结果 74例均发生于鼻咽后鼻孔区,圆形或椭圆形32例(43.2%),不规则形42例(56.8%);边缘光滑18例(24.3%),分叶状56例(75.7%)。与脑灰质相比,74例中,T1WI等信号69例(93.2%),稍低信号5例(6.8%),信号均匀;T2WI高信号66例(89.1%),等信号为主8例(10.9%);信号不均匀66例(89.1%),信号均匀8例(10.9%);流空信号61例(82.4%),流空信号不明显13例(17.6%);明显不均匀强化49例(66.2%),均匀强化25例(33.8%)。74例MRI分期结果(括号内是手术分期)是:Ⅰa期6例(6例),Ⅰb期2例(2例);Ⅱa期5例(5例),Ⅱb期20例(20例),Ⅱc期14例(18例);Ⅲa期18例(13例),Ⅲb期9例(10例),与临床手术分期相对照,MRI分期准确性高(Kappa值0.92)。结论鼻咽纤维血管瘤MRI影像学表现有一定特征,MRI影像分期可作为术前分期依据。Objective：To evaluate MR imaging findings and the value of its imaging stage of nasopharyngeal angiofibroma.Materials and Methods：Imaging findings of seventy-four patients with nasopharyngeal angiofibroma confirmed by pathology were studied,including：location,configuration,margin,signal intensity,homogeneity of T2 weighted image,enhancement pattern,and signal voids.To record the invovled sites and structures of every case and underlines the imaging stage,the accuracy of MR imaging staging system were evaluated.Results：All 74 cases originated from the nasopharyngeal space.Other imaging features including：configuration of round and ovoal in 32 cases（43.2%）,irregularity in 42 cases（56.8%）,margin of smooth in 18 cases（24.3%）,lobular in 56 cases（75.7%）.Comparing with gray matter of brain,iso-intensity in 69 cases（93.2%）,hypo-intensity in 5 cases（6.8%） on T1 weighted images,hyper-intensity in 66 cases（89.1%）,iso-intensity in 8 cases（10.9%） on T2 weighted images.T2 signal is homogeneous in 8 cases（10.9%）,heterogeneous in 66 cases（89.1%）,and cystic area was demonstrated in two cases.Markedly heterogeneous enhancement was exhibited in 49 cases（66.2%） and homogeneous enhancement in 25 cases（33.8%） after contrast injection.Signal voids in 61 cases（82.4%） of 74 cases.The results of MR imaging stage of 74 cases is：Ⅰa stage 6 cases（6 cases）,Ⅰb stage 2 cases（2 cases）,Ⅱa stage 5 cases（5 cases）,Ⅱb stage 20 cases（20 cases）,Ⅱc stage 14 cases（18 cases）,Ⅲa stage 18 cases（13 cases）,Ⅲb stage 9 cases（10 cases）.Conclusion：MR imaging feature is characteristic for nasopharyngeal angiofibroma.MR imaging stage system can be used as the preoperation stage of nasopharyngeal angiofibroma in clinics.

关 键 词：纤维血管瘤 鼻咽疾病 磁共振成像 肿瘤分期 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.4[医药卫生—诊断学]