鼻腔鼻窦少见良性肿瘤及类肿瘤样病变的CT和磁共振成像诊断  

CT and MRI diagnosis of rare benign tumors and tumor-like lesions in nasal cavity and sinus

作　　者：向世凤 李必强 杨健 黄显龙 熊华 XIANG Shifeng;LI Biqiang;YANG Jian;HUANG Xianlong;XIONG Hua(Department of Radiology,Chongqing General Hos pital,Chongqing 400014,China)

机构地区：[1]重庆市人民医院放射科,重庆400014

出　　处：《实用放射学杂志》2020年第6期880-884,共5页Journal of Practical Radiology

摘　　要：目的探讨CT和MRI对鼻腔鼻窦少见良性肿瘤及类肿瘤样病变的诊断价值。方法回顾性分析经手术及病理证实的22例临床少见鼻腔鼻窦良性肿瘤及类肿瘤样病变CT及MRI影像资料,总结其影像特征。结果鼻腔鼻窦良性肿瘤及类肿瘤样病变22例,多形性腺瘤2例、神经鞘瘤3例、呼吸道上皮腺瘤样错构瘤2例、鼻腔鼻窦型血管外皮细胞瘤2例、孤立性纤维瘤1例、出血坏死性鼻息肉8例、胆固醇性肉芽肿4例。病灶边界清楚20例(90.9%),非侵袭性生长18例(81.8%),轻度骨质破坏8例(36.4%),明显骨质破坏1例(4.5%)。2例多形性腺瘤T1 WI呈等/略低信号、T2 WI为稍高信号,其内多发小囊性灶;2例神经鞘瘤均匀强化,1例不均匀强化;1例出血坏死性鼻息肉CT未见明显强化,其余7例不均匀强化,2例MRI信号混杂,1例灶周围低信号环及内部分隔。结论鼻腔鼻窦少见良性肿瘤及肿瘤样病变CT及MRI表现各有一定的特征,常规CT和MRI检查能清楚显示病变部位、血供及周围结构的关系,对诊断及临床制订治疗方案具有重要意义。Objective To evaluate the diagnostic value of CT and MRI in rare benign tumors and tumor-like lesions in nasal cavity and sinus.Methods CT and MRI images data of 22 patients with clinically rare benign tumors and tumor-like lesions in nasal cavity and sinus confirmed by surgery and pathology were analyzed retrospectively,and the image features were summarized.Results 22 cases of benign tumors and tumor-like lesions in nasal cavity and sinus were found including 2 cases of pleomorphic adenoma,3 cases of schwannoma,2 cases of respiratory epithelial adenomatoid hamartoma,2 cases of sinonasal-type hemangiopericytoma,1 case of solitary fibrous tumor,8 cases of hemorrhagic and necrotic nasal polyps and 4 cases of cholesterol granuloma.20(90.9%)lesions had clear boundaries,18(81.8%)had non-invasive growth pattern,8(36.4%)had mild bone destruction and 1(4.5%)had obvious bone destruction.2 pleomorphic adenomas showed moderate/slightly low signal on T1 WI and slightly high signal on T2 WI,with inner multiple small cystic changes.2 schwannomas were homogeneously enhanced and 1 was with heterogeneous enhancement.Of the 8 cases of hemorrhagic and necrotic nasal polyp,there was no obvious enhancement on CT image in 1 case,heterogeneous enhancement in the other 7 cases,mixed signals on MRI in 2 cases,and low signal ring and internal separation of the lesion in 1 case.Conclusion The CT and MRI findings of rare benign tumors and tumor-like lesions in the nasal cavity and sinus are with certain characteristics.Routine CT and MRI can clearly show the relationship among the lesion site,blood supply and surrounding structure,which is of great significance for the diagnosis and the clinical treatment plan.

关 键 词：鼻腔 鼻窦 良性肿瘤 类肿瘤样病变 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]