蝶窦气化停滞的影像学表现及鉴别诊断  

Imaging features and differential diagnosis of arrested pneumatisation of the sphenoid sinus

作　　者：闫钟钰[1] 刘承耀[2] 王新艳[1] 李铮[1] 杨本涛[1] 鲜军舫[1] YAN Zhongyu;LIU Chengyao;WANG Xinyan;LI Zheng;YANG Bentao;XIAN Junfang(Department of Radiology,Key Laboratory of Otolaryngology Head and Neck Surgery(Capital Medical University),Ministry of Education,Beijing Tongren Hospital,Capital Medical University,Beijing,100730,China;Department of Otolaryngology Head and Neck Surgery,Key Laboratory of Otolaryngology Head and Neck Surgery(Capital Medical University),Ministry of Education,Beijing Tongren Hospital,Capital Medical University,Beijing,100730,China)

机构地区：[1]首都医科大学附属北京同仁医院放射科,北京100730 [2]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,耳鼻咽喉头颈外科学教育部重点实验室(首都医科大学),北京100730

出　　处：《中国耳鼻咽喉头颈外科》2024年第7期451-455,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的分析蝶窦气化停滞的CT和MRI影像学表现,并与蝶骨区骨、软骨源性肿瘤及肿瘤样病变鉴别。方法回顾性分析13例蝶窦气化停滞和20例蝶骨区骨源性肿瘤的CT及MRI资料,包括发生部位、大小、密度、有无膨胀、钙化、骨皮质改变,MRI信号、抑脂后信号改变、强化程度、邻近结构改变等,并进行统计学比较。结果蝶窦气化停滞多见于蝶骨体(4例)、翼突(3例)和多部位受累(6例)。停滞区域以混合密度为主,最长径为0.8~4.1 cm,钙化7例,无膨胀性改变13例,骨皮质完整13例;MRI T1WI高信号11例,等信号2例,T2WI高信号10例,等信号3例,抑脂后信号减低13例,无明显强化10例,轻微强化3例。邻近结构无改变13例。结论蝶窦气化停滞是少见解剖变异,以混合密度为主,骨皮质完整,无膨胀性改变,MRI抑脂信号减低,无明显强化有助于鉴别。OBJECTIVE To Analysis of CT and MRI imaging features of arrested pneumatisation of the sphenoid sinus and differentiate from osteogenic and chondrogenic tumours of the region.METHODS Retrospective analysis of CT and MRI findings was performed of 13 patients with sphenoid sinus arrested pneumatisation and 20 patients with osteogenic and chondrogenic tumours and tumor like lesions in the same period.Evaluation indicators included location,size,density,presence of expansive changes,calcification,cortical bone changes,MRI signal characteristics,signal changes after fat suppression,degree of enhancement,and statistical analysis was conducted.RESULTS Finally,the location includes the sphenoid body(4 cases),pterygoid process(3 cases)and multiple involved areas(6 cases).The arrested pneumatisation area is mainly characterized by fat density or mixed density of adipose and soft tissue.The longest diameter of the arrested pneumatisation zone is 0.8-4.1 cm.There is internal calcification(7 cases)and without bone expansive changes(13 cases).Cases with intact bone cortex(13 cases);On MRI T1WI,high signal(11 cases),equal signal(2 cases),on T2WI,high signal(10 cases),equal signal(3 cases).Decreased signal after fat suppression(13 cases),no significant enhancement(10 cases),and slight enhancement(3 cases).CONCLUSION The arrested pneumatisation of sphenoid sinus is a rare anatomical variation characterized by a mixed density of fat or soft tissue,intact bone cortex,without bone expansive changes,decreased signal of MRI fat suppression,and no obvious enhancement,which will help to differentiate from osteogenic and chondrogenic tumours of the region.

关 键 词：蝶窦 颅底 解剖变异 气化停滞 

分 类 号：R739.6[医药卫生—肿瘤]