原发性颞下窝肿瘤的CT与MRI特点分析  

CT and MRI features of primary infratemporal fossa tumor

作　　者：刘红生[1] 董季平[1] 白岫峰[2] 杨想春[1] 杨军乐[1] 

机构地区：[1]西安交通大学附属西安市中心医院放射科,陕西西安710003 [2]西安交通大学口腔医院颌面外科

出　　处：《实用放射学杂志》2016年第11期1672-1675,共4页Journal of Practical Radiology

摘　　要：目的探讨原发性颞下窝肿瘤的CT、MRI表现特点。方法回顾性分析经手术或穿刺病理证实的21例原发性颞下窝肿瘤的CT及MRI资料，分析其影像学表现。结果21例中良性肿瘤10例（47．6％），包括血管瘤4例，神经鞘瘤2例，神经纤维瘤3例，脂肪瘤1例；恶性肿瘤】1例（52．4％），包括横纹肌肉瘤3例，滑膜肉瘤2例，腺样囊性癌2例，腺泡状软组织肉瘤2例，纤维肉瘤和淋巴瘤各1例。血管瘤呈渐进性显著强化，常伴钙化，MRI T2WI病灶内见流空信号。神经鞘瘤表现为不均匀强化的软组织肿块，伴有出血、坏死、囊变。神经纤维瘤密度／信号较均匀，内含有散在钙化灶。脂肪瘤CT及MRI均表现为脂肪密度／信号肿块，边界清晰。横纹肌肉瘤、纤维肉瘤及淋巴瘤浸润性生长并向邻近间隙蔓延，增强扫描均匀或不均匀强化。滑膜肉瘤边界较清楚，强化明显，可伴不规则钙化。腺样囊性癌表现为浸润性生长的软组织肿块，内可见“筛状”改变。腺泡状软组织肉瘤为不均匀软组织肿块，病灶中央及周边有流空血管为其特征性影像学表现。结论颞下窝原发性肿瘤少见，熟悉其影像学特点有利于提高诊断及鉴别诊断水平。Objective To explore CT and MRI features of primary infratemporal fossa tumor. Methods Image features of 21 cases of primary infratemporal fossa tumors proved pathologically and surgically were retrospectively analyzed. Results Among 21 cases, benign tumor（ 10 cases） accounted for 47.6%, including 4 hemangiomas, 2 schwannomas, 3 neurofibromas and 1 lipoma. Malignant tumor（11 cases） accounted for 52.4%, including 3 rhabdomyosarcomas, 2 synovial sarcomas, adenoid cystic carcinomas and alveolar soft part sarcomas respectively, 1 fibrosarcoma and 1 lymphoma. On contrast enhanced CT and MRI scans, hemangioma demonstrated gradually remarkable enhancement, could be associated with calcifications, and flow voids could be seen on T2WI. Schwannoma manifested soft tissue mass and showed inhomogeneous enhancement, which accompanied with hemorrhage, necrosis and cystic degeneration. Neurofibroma showed relatively homogeneous density/signal and contained scattered calcifications. Lipoma showed a well delineated mass with fat attenuation/intensity. Rhabdomyosareoma, fibrosarcoma and lymphoma showed invasive growth and spreaded to the neighboring space, with homogeneous or inhomogeneous enhancement. Synovial sarcoma had a well defined border and marked enhancement, with irregular calcifications. Adenoid cystic carcinoma presented soft tissue mass of invasive growth, and ＂cribriform＂ change could be seen. Alveolar soft part sarcoma displayed soft tissue mass with marked heterogeneous enhancement, which was characterized by flow void vessels observed in the central and peripheral of the lesions. Conclusion Primary infratemporal fossa tumor is rare, familiarity with the imaging characteristics can be used to improve the abilities of diagnosis and differential diagnosis.

关 键 词：颞下窝 原发性肿瘤 计算机体层成像 磁共振成像 

分 类 号：R739.91[医药卫生—肿瘤] R814.42[医药卫生—临床医学]