鼻腔原发性恶性黑色素瘤的CT及MRI分析  

CT and MRI Features of Primary Malignant Melanoma in the Nasal Cavity

作　　者：丁爽[1] 黄玉洁[1] 米日古丽.沙依提 王金英[1] 

机构地区：[1]新疆医科大学第一附属医院影像中心

出　　处：《中国医学计算机成像杂志》2017年第1期26-29,共4页Chinese Computed Medical Imaging

摘　　要：目的:探讨鼻腔原发性恶性黑色素瘤的CT及MRI特征,以帮助诊断。方法:经病理证实的13例鼻腔原发性恶性黑色素瘤患者(女8例,男5例,平均年龄70.8岁)纳入研究,分析其CT及MRI表现,包括病灶部位、侵及范围、骨质破坏、密度/信号特点以及增强后强化程度等。结果:12例病灶发生在单侧鼻腔,1例发生在双侧;12例(12/13)邻近骨质吸收伴部分破坏;肿瘤呈稍低、等及稍高的软组织密度;9例(9/12)在T2WI上与脑实质信号比较呈等或稍低信号,3例(3/12)呈等、高混杂信号,2例(2/12)在T1WI上呈明显高信号,10例(10/12)呈等及稍低信号;增强扫描后3例(3/12)明显强化,9例(9/12)呈轻中度强化。结论:CT和MRI能很好地显示肿瘤的部位、周围骨质破坏和邻近重要结构的侵犯,鼻腔原发性恶性黑色素瘤MR-T2WI等或稍低信号、轻中度强化,具有一定的特征性可帮助诊断;但T2WI稍高信号表现是不典型的,诊断需依靠病理检查。Purpose： To investigate the imaging features of primary malignant melanoma （MM） in the nasal cavity, and to improve the clinical diagnosis. Methods： Imaging findings of 13 patients with pathologically confirmed MM were retrospectively reviewed. The age, gender, location, size, bone destruction, density or signal intensity, enhancement characteristics of all lesions were evaluated. Results：There were 8 women and 5 men in 13 patients, their mean age was 70.8 years old. Twelve cases occurred in unilateral nasal cavity and 1 case occurred in bilateral nasal cavity. Adjacent bone absorption and bone destruction were shown in twelve cases （12/13）. CT scans showed that the tumors were with soft-tissue density. Compared to the signal intensity of gray matter of the brain, 9 cases （9/12） demonstrated iso-intensity or hypo-intensity on T2WI, 2 cases （2/12） demonstrated obviously hyper-intensity on T1W1, and 10 cases （10/12） appeared iso-intensity or hypo-intensity on T1WI. Apparent enhancement was shown in 3 cases （3/12）, and slight or moderate enhancement was shown in 9 cases （9/12）. Conclusion： The location of tumor, invasion of bone and the adjoining structures can be well defined by CT and MRI. Primary malignant melanoma in the nasal cavity shows characteristic MR signal intensity （iso- or hyposignal intensity on T2WI, and with slight or moderate enhancement）, which may provide valuable information for diagnosis. However, the diagnosis of atypical malignant melanoma （hyper-signal intensity on T2WI） still depend on the pathology result.

关 键 词：鼻腔 黑色素瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R445.3[医药卫生—诊断学]