鼻腔、鼻咽、口腔恶性黑色素瘤的MRI表现  

MRI appearance of malignant melanoma in the nasal cavity,nasopharynx and the oral cavity

作　　者：陈加优[1] 郑祥[1] 廖江[1] 陈韵彬[1] 陈英[1] 

机构地区：[1]福建省肿瘤医院放诊科,福建福州350014

出　　处：《中国医药导报》2015年第10期126-129,共4页China Medical Herald

基　　金：国家临床重点专科建设资助项目(闽卫医函[2011]1018号)

摘　　要：目的分析鼻腔、鼻咽、口腔恶性黑色素瘤的MRI表现,探讨其诊断要点。方法回顾性分析2009年1月~2013年9月福建省肿瘤医院经活检或手术病理证实的12例鼻腔、鼻咽、口腔恶性黑色素瘤的MRI特征及临床资料,所有患者均行MRI平扫及增强检查。结果肿瘤位于鼻腔9例,鼻咽部2例,口腔上腭部1例。6例可见明显骨质破坏并侵犯邻近结构,累及翼腭窝1例、筛窦6例、眼眶4例、上颌窦4例、额窦、额骨、脑膜1例。1例鼻腔恶性黑色素瘤累及鼻咽,1例鼻咽恶性黑色素瘤累及鼻腔。12例最大径〉2 cm,呈类圆形或不规则肿块,MRI表现为混杂信号,T1WI以等信号为主,其内散在斑片状高信号,分布以周边为主;在T2WI,3例以高低信号为主,9例以稍高信号为主,增强扫描3例呈轻度不均匀强化,9例呈明显不均匀强化。结论鼻腔、鼻咽、口腔恶性黑色素瘤MRI信号有一定特征性,T1WI病灶内散在斑片状高信号且以周边分布为主有助于正确诊断。Objective To analyze the MRI appearance of malignant melanoma in the nasal cavity,nasopharynx and the oral cavity and explore its diagnostic points.Methods MRI findings and clinical data of 12 patients with malignant melanoma proved by biopsy or operation from January 2009 to September 2013 in Fujian Provincial Cancer Hospital were retrospectively reviewed.Routine scanning and gadolinium-enhanced imaging scanning were performed in all cases.Results The majority of lesions were located in the nasal cavity（n=9）,nasopharynx（n=2）,the upper palate of oral cavity（n=1）.The aggressive nature of the tumors was demonstrated by bone destruction and invasion of adjacent structures（n=6）,involving pterygopalatine fossa（n=1）,sinuses ethmoidei（n=6）,orbits（n=4）,sinuses maxillaries（n=4）,frontal sinus,frontal bone and dura（n=1）.One case of malignant melanoma of nasal cavity with nasopharynx invaded.One case of nasopharyngeal malignant melanoma with the nasal cavity invaded.The MRI appearances of the lesions were quasi-circular or irregular（the largest diameter more than 2 cm）.They showed heterogeneous equal signal on T1 WI.Patchy high signals were scattered within lesions and mostly appeared around the lesions.On T2 WI,3 lesions showed mixed signal intensities（high and low）,and 9 lesions showed slightly high signal intensity.3 patients demonstrated mild heterogeneous enhancement on gadolinium-enhanced images while 9 patients with obvious heterogeneous enhancement after contrast agent injection.Conclusion The MRI signal of the malignant melanoma in the nasal cavity,nasopharynx and the oral cavity owns certain characteristic features.Patchy high signals is scattered within lesions and mostly appears around the lesions,and may help in accurate diagnosis on T1 WI.

关 键 词：黑色素瘤 鼻咽肿瘤 鼻腔 口腔 磁共振成像 

分 类 号：R739.62[医药卫生—肿瘤]