CT和MRI对原发鼻腔鼻窦结外鼻型NK/T细胞淋巴瘤的临床诊断价值  

CT and MRI in the diagnosis of extra-nodal nasal type NK/T cell lymphoma originating in the nasal cavity or sinus

作　　者：魏先梅[1] 麻晓峰[1] 窦鑫[2] 俞晨杰[1] 陈峰[1] WEI Xian-mei1,MA Xiao-feng1,DOU Xin2,YU Chen-jie1,CHEN Feng1(1.Department of Otolaryngology Headand Neck Surgery,2.Department of Radiology,Affiliated Drum Tower Hospi-talof Nanjing University Medical School/Jiangsu Provincial Key Medical Discipline Laboratory,Research Institutionof Otolaryngology,Drum Tower Hospital,Nanjing 210008,Jiangsu,Chin)

机构地区：[1]南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科(南京鼓楼医院耳鼻咽喉研究所),南京医学硕士210008 [2]南京大学医学院附属鼓楼医院放射科(南京鼓楼医院耳鼻咽喉研究所),南京210008

出　　处：《医学研究生学报》2018年第5期481-484,共4页Journal of Medical Postgraduates

基　　金：国家自然科学基金(81670928);江苏省科教强卫工程项目江苏省重点学科资助(ZDXKB2016015)

摘　　要：目的原发鼻腔鼻窦结外鼻型NK/T细胞淋巴瘤(ENKTCL)早期诊断困难,有一定的误诊率。文中旨在分析和总结原发鼻腔鼻窦ENKTCL的CT和MRI表现,探讨CT和MRI对原发鼻腔鼻窦ENKTCL的临床诊断价值。方法回顾性分析2012年1月至2017年12月南京鼓楼医院耳鼻咽喉头颈外科13例原发鼻腔鼻窦ENKTCL的临床资料及影像学资料。分别行CT平扫、增强及MRI平扫、增强,分析CT表现和MRI表现。结果 13例患者CT平扫示鼻腔鼻窦内软组织密度影,肿瘤内密度尚均匀,骨窗可显示骨质破坏,主要表现为鼻腔中线及鼻窦区域软组织肿块伴骨质破坏,骨质破坏多表现为骨质浸润性吸收,病变软组织范围明显大于骨质破坏范围。10例患者CT增强后肿瘤呈轻至中度不均匀强化。10例患者MRI平扫肿瘤显示T1WI等信号,T2WI呈稍高信号,强化后呈轻度到中度不均匀强化。10例患者伴阻塞性鼻窦炎,T1WI呈低信号,T2WI呈高信号,增强后边缘强化。结论原发于鼻腔鼻窦ENKTCL的CT和MRI表现有一定的特征性,结合患者临床表现及体征,常规行CT和MRI检查能够较准确的描述病变的部位及侵犯范围,对于临床早期诊断及评估疾病预后有重要的临床意义。Objective Early diagnosis of extra-nodal nasal type NK/T cell lymphoma（ ENKTCL） is difficult and it is often misdiagnosed. This article was to analyze the CT and MRI findings of ENKTCL originating in the nasal cavity or sinus and investigate the values of CT and MRI in the diagnosis of the disease. Methods We retrospectively analyzed the clinical data and CT and MRI findings about 13 cases of ENKTCL originating in the nasal cavity or sinus examined in our hospital from January 2012 to December2017. Results Non-contrast CT scanning displayed soft tissue density shadow in the nasal cavity or sinus,with homogeneous density in the tumor and soft tissue mass with bony destruction（ mostly infiltrative absorption） in the midline nasal cavity and sinal area,and the area of soft tissue lesion was obviously larger than that of bony destruction. Ten cases of contrast-enhanced CT of the tumor manifested mild to moderate heterogeneous density; 10 cases of plain MRI presented isointensity of T1 WI and slightly increased intensity of T2 WI,while enhanced MRI showed mild to moderate heterogeneous density.Low-intensity T1 WI,high-intensity T2 WI and edge-enhancement wereobserved in the 10 cases accompanied by obstructive sinusitis. Conclusion ENKTCL originating in the nasal cavity or sinus has its own specific CT or/and MRI manifestations. Conventional CT or/and MRI combined with clinical signs and symptoms can accurately determine the site of lesion and scope of invasion and is therefore of important clinical significance for the early diagnosis and prognosis of the disease.

关 键 词：结外鼻型NK/T细胞淋巴瘤 鼻腔 鼻窦 计算机断层扫描 磁共振成像 

分 类 号：R782.1[医药卫生—口腔医学]