Tornwaldt囊肿的临床、MRI和DWI表现  

Appearance of Clinical MRI and DWI in Tornwaldt's Cyst

作　　者：丁磊[1] 高振华[1,2] 何天生 罗柏宁[1] 

机构地区：[1]中山大学附属第一医院放射科,广州510080 [2]中山大学附属第一医院惠亚医院放射科,惠州516081

出　　处：《临床放射学杂志》2016年第5期702-705,共4页Journal of Clinical Radiology

摘　　要：目的分析Tornwaldt囊肿的临床、MRI和扩散加权成像（DWI）表现特征。方法回顾性分析8500例包括鼻咽部的头部MRI图像资料,其中年龄3天~14岁330例,15~82岁8170例。观察Tornwaldt囊肿的出现率、MRI和DWI表现特征。结果 8500例中发现Tornwaldt囊肿23例（0.27%）,年龄10~75岁,在儿童中仅发现1例。病变均为单发,与脑干信号比较,平扫T_1WI呈低信号7例、等信号11例和高信号5例,10例DWI呈低信号4例、高信号6例。11例MR增强后均无强化。21例横轴位MRI,15例位于鼻咽部顶后壁正中线,各有3例分别位于中线偏左或偏右侧头长肌前方;13例呈圆形,6例呈纵椭圆形和2例呈横椭圆形。15例矢状位MRI上椭圆形病变的最大径与枕骨斜坡的长轴成锐角关系10例、成平行关系4例和成钝角关系1例。结论 Tornwaldt囊肿罕见于儿童,位于鼻咽顶后壁正中线、中线偏左或右侧,在横轴位图像上多呈圆形和纵椭圆形,在矢状位图像上病变最大径与枕骨基底部长轴常成锐角关系,T_1WI和DWI上可呈低、等或高信号多种表现。Objective To investigate the clinical,MR imaging and Diffusion weightedimaging characteristics of Tornwaldt＇s cysts. Methods MR images of the brain in 8500 cases（ including 330 cases aged from 3 days to 14 years,and8170 cases aged 5- 82years） were reviewed. The incidence,MRI and DWI findings of Tornwaldt＇s cyst were observed.Results Tornwaldt＇s cysts were found in 23 of 8500 cases（ 0. 27%）,with age range of 10- 75 years. Only one cyst was found in these 330 children. The cysts were single,showing hypointensity in 7 patients,isointensity in 11 patients as well as hyperintensity in 5 patients when compared with that of brainstem on T_1WI. There were no enhancements in 11 patients on the contrastenhanced MR images. In 10 patients with DWI scanning,the lesion appeared as hypointense（ 4 patients）and hyperintense（ 6 patients）. In 21 patients with the axial MR images,the lesions were located in the midline（ 15 patients）,left paramidline（ 3 patients） or right paramidline（ 3 patients） of the posterior top wall of nasopharynx. Tornwaldt＇s cysts appeared round in 13 patients,longitudinally oval in 6 patients and transversely oval in 2 patients on the axial MR images. In 15 patients with the sagittal MR scanning,the maximum diameter of the cyst with the long axis of the occipital basis became the sharp angle in 10 patients,parallel in 4 patients,and obtuse angle in 1 patient. Conclusion Tornwaldt＇s cyst extremely seldom occurs in children,which may be located in the midline,left or right paramidline of nasopharyngeal posterior wall. Most of Tornwaldt＇s cysts were round and longitudinally oval on the axial MR images. The maximum diameter of the cyst with the long axis of the occipital basis often becomes the sharp angle on the sagittal MR images.Tornwaldt＇s cyst is adverse in signal intensity on T_1WI and DWI.

关 键 词：TORNWALDT囊肿 磁共振成像 扩散加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R766[医药卫生—诊断学]