鼻腔鼻窦原发恶性黑色素瘤的影像学表现  

Imaging findings of primary malignant melanomas in the nasal cavity and paranasal sinuses

作　　者：尹如娇 朱云[1] 赵卫[1] 孙学进[1] 

机构地区：[1]昆明医科大学第一附属医院医学影像科,云南昆明650032

出　　处：《实用放射学杂志》2017年第1期24-27,共4页Journal of Practical Radiology

摘　　要：目的分析鼻腔鼻窦原发恶性黑色素瘤CT及MR表现，探讨其诊断要点。方法回顾性分析经活检或手术病理及免疫组化证实的16例鼻腔鼻窦恶性黑色素瘤的CT、MR特征及临床资料，均行CT平扫及增强，其中9例行MR平扫及增强。结果16例CT表现均为单侧发病；肿瘤位于鼻腔8例，鼻窦4例，同时累及鼻腔、鼻窦4例；形态欠规整，呈软组织密度，其内未见钙化和囊变；周围组织均受侵；增强后不均匀中一重度强化。9例MR表现均为单侧发病；肿瘤位于鼻腔4例，鼻窦3例，同时受累鼻腔、鼻窦2例；形态欠规则，1例呈T1WI高信号，T2WI低信号，3例呈T1WI等信号，T2WI等／稍高信号，5例呈混杂信号。增强后不均匀轻一中度强化；周围组织均有侵犯。结论鼻腔鼻窦原发恶性黑色素瘤CT表现缺乏特异性；典型恶性黑色素瘤有MR特征性表现，但罕见，以非色素及混合型常见。CT联合MRI能准确显示肿瘤部位及与周围组织、邻近骨质的关系。Objective To analyze the CT and MR manifestations and the diagnosis of primary malignant melanoma in the nasal cavity and paranasal sinuses.Methods CT, MR features and clinical data of 16 cases of malignant melanoma in the nasal cavity and paranasal sinuses, which were confirmed by biopsy or surgical pathology and immunohistoehemistry were analysed retrospectivelly. CT routine and enhanced scan were performed in all patients,MR routine and enhanced scan were performed in 9 cases.Results CT findings of 16 patients were unilateral,in which 8 cases were located in the nasal cavity,4 cases in the paranasal sinuses, and 4 cases were both in the nasal cavity and paranasal sinuses.All lesions were irregular shape with soft tissue densityand without calcification and cystic degeneration and demonstrated invasiveness to the surrounding tissue. Lesions were nonuniformly moderate to severe en- hancement. Among 9 patients with MR examination,lesions were mainly unilateral in which 4 cases were in the nasal cavity,3 cases in the paranasal sinuses,2 cases both in the nasal cavity and paranasal sinuses.Lesions were irregular in 9 cases, in which 1 case had typical high signal on T1WI, low signal on T2WI,while 3 cases equal signal on T1WI, equal or slightly higher signal on T2WI and 5 cases mixed signal. On MR enhanced scan, unevenly slight-medium enhancement were showed in the lesion and surrounding tissues. Conclusion Primary malignant melanoma of the nasal cavity and paranasal sinuses is lack of specificity on CT imaging. Typical ma- lignant melanoma, a type of rare to finding, has certain characteristics on MR j non-pigment type and mixed type are more common. CT combined with MRI can better show the site of the tumor, and the relation with surrounding tissues and adjacent bones.

关 键 词：鼻腔 鼻窦 原发恶性黑色素瘤 计算机体层成像 磁共振成像 

分 类 号：R739.62[医药卫生—肿瘤] R814.42[医药卫生—临床医学]