上颌窦肿块的影像学分析  

Imaging Analysis of Maxillary Sinus Tumors

作　　者：孙金磊[1] 王振常[2] 

机构地区：[1]首都医科大学石景山教学医院北京市石景山医院,北京100043 [2]首都医科大学附属北京友谊医院

出　　处：《中国医学创新》2015年第26期54-58,共5页Medical Innovation of China

摘　　要：目的:探讨上颌窦占位病变的影像学特征,提高诊断和鉴别诊断水平。方法:回顾性分析89例经病理证实的上颌窦肿块的CT及MRI表现。结果:内翻乳头状瘤25例均与鼻腔内肿块相连。CT:72.7%表现为中等软组织密度,13.6%可见钙化,邻近骨质72.7%受压变形,45.5%骨质吸收,18.2%骨质破坏。MRI:T1WI为等或略低信号,T2WI为等或高信号,信号较混杂,增强后不均匀强化,83.3%呈"脑回状"强化。出血坏死性息肉6例,均位于上颌窦囟门部,呈分叶状。CT:密度不均匀。MRI:T1WI呈略低信号,T2WI中央区呈高信号,周围呈环形低信号影。增强后明显不均匀强化。鳞状细胞癌23例,表现为上颌窦内肿块沿窦壁向外浸润性增厚或形成不规则肿块。CT:52.4%密度不均匀,4.8%可见钙化,均伴有窦壁骨质破坏,其中82.4%可见内壁骨质破坏。MRI:T1WI等信号,T2WI等信号或低信号,增强后多不均匀强化。腺样囊性癌9例,CT:57.1%密度不均匀,MRI:T1WI呈低、等或稍高信号,T2WI表现为高或高低混杂信号,增强后不均匀强化。其他少见肿块亦各有特点。结论:CT能够显示骨质改变,对判断良恶性有重要价值;MRI能够显示肿块的病理特征及其周围受累结构的改变,对其定性诊断及临床分期具有指导意义;二者结合可以提供更全面的影像信息。Objective： To investigate the imaging findings of maxillary sinus tumors in order to improve the levels of diagnosis and differential diagnosis.Method： CT and MRI data of 89 cases with maxillary sinus tumors confirmed histopathologically were analyzed retrospectively.Result： Inverted papilloma, 25 cases were connected with the nasal mass.CT： 72.7% showed moderate soft-tissue density, 13.6% visible calcification, close to 72.7% compression deformation of bone, 45.5% bone absorption, 18.2% bone destruction.MRI： The leisions showed isointensity or slight hypointensity on T1WI and isointensity or slight hyperintensity on T2WI.Postcontrast MR showed heterogeneous enhancement and 83.3% showed ＂cerebriform＂ enhancement.Hemorrhagic and necrotic polyps, 6 cases were lobulated and located in the maxillary sinus fontanelle Department.CT： heterogeneous density.MRI： T1WI showed slightly lower signal, T2WI showed high signal central area with a low signal intensity rim.Postcontrast MR showed obviously heterogeneous enhancement.Squamous cell carcinoma, 23 cases showed the masses along the outside wall of the maxillary sinus formed invasive irregular thickening or tumors.CT： 52.4% asymmetrical density, 4.8% visible calcification, associated with bone destruction of sinus wails, of which 82.4% could be seen inwall bone destruction.MRI： T1WI showed hypointensity, isointensity or slight hyperintensity, T2WI showed isointensity or hypointensity, and postcontrast MR showed inhomogeneous enhancement.Of adenoid cystic carcinoma in 9 cases, CT： 57.1% uneven density.MRI： The leisions showed hypointensity, isointensity or slight hyperintensity on TIWI and hyperintensity or inhomogeneous intensity on T2WI.Postcontrast MR showed inhomogeneous enhancement.Other rare tumor had its own characteristics.Conclusion： CT provides clear view of bone changes and has an important value in benign and malignant. MRI which can show the pathological features of tumors and demonstrate optimally the extent of the lesions suggests

关 键 词：上颌窦 X线计算机 体层摄影术 磁共振成像 

分 类 号：R739.6[医药卫生—肿瘤]