颅颈部腺样囊性癌侵犯神经孔、管的影像学分析  

Imaging analysis of craniocervical adenoid cystic carcinoma with invading neural foramen and tube

作　　者：包宏伟[1] 茆松 张维天[2] 庄奇新[3] 陆靖[3] 诸晋煜 BAO Hongwei;MAO Song;ZHANG Weitian;ZHUANG Qixin;LU Jing;ZHU Jinyu(Department of Radiology,Jinshan Branch of Shanghai Sixth People's Hospital,Shanghai 201599,China;Department of Head and Neck Surgery,Shanghai Sirth People's Hospital,Shanghai 200233,China;Department of Radiology,Shanghai Sirth People's Hospital,Shanghai 200233,China)

机构地区：[1]上海市第六人民医院金山分院放射科,上海201599 [2]上海市第六人民医院头颈外科,上海200233 [3]上海市第六人民医院放射科,上海200233

出　　处：《实用放射学杂志》2024年第9期1421-1424,共4页Journal of Practical Radiology

基　　金：上海申康医院发展中心新兴前沿技术联合攻关项目(SHDC12020129)。

摘　　要：目的 探讨颅颈部腺样囊性癌(ACC)侵犯相邻组织和神经孔、管的影像学表现.方法 回顾性分析33例颅颈部ACC侵犯相邻组织和颅底神经孔、管的CT和MR影像表现,并与手术、病理结果进行比较.结果 33例ACC中,位于鼻腔、鼻窦和鼻咽部17例(包括3例手术后复发),涎腺8例,泪腺泪囊5例,外耳道3例.肿瘤侵犯和破坏相邻肌束、间隙、鼻腔、鼻窦、骨壁16例,侵犯翼腭窝9例、翼管7例、圆孔6例、卵圆孔5例、鼻泪管3例、茎乳孔2例、外耳道3例(共35个孔管).肿瘤侵犯相邻肌束、间隙、鼻腔、鼻窦、颅底部时,CT或MR可见肿瘤周围组织增厚,密度、信号异常,明显强化,肿瘤侵犯相邻骨和软骨以及神经孔、管时,CT可见骨壁增厚、变薄或缺失,相邻神经孔管扩大、管壁增厚、骨质破坏.结论 CT和MR能很好地显示肿瘤内多发小囊泡、筛孔样结构等影像学特征以及颅颈部ACC对相邻组织的侵犯和颅底、颌面部神经孔、管的破坏,其对颅颈部ACC的影像学诊断和手术治疗有重要意义.Objective To investigate the imaging findings of craniocervical adenoid cystic carcinoma(ACC)with invading adjacent tissues,neural foramen and tube.Methods The CT and MR imaging features of 33 cases of craniocervical ACC with invading adja-cent tissues,neural foramen and tube of the basis cranii were analyzed retrospectively and compared with surgical and pathological results.Results Among 33 cases of ACC,17 cases were located in the nasal cavity,sinuses and nasopharynx(including 3 cases of recur-rence after surgery),8 cases in salivary gland,5 cases in lacrimal gland and lacrimal sac,and 3 cases in external auditory canal.Tumors invaded and destroyed adjacent muscle bundles,spaces,nasal cavity,sinuses,and bone walls in 16 cases,invaded pterygopala-tine fossa in 9 cases,pterygoid canal in 7 cases,foramen rotundum in 6 cases,foramen ovale in 5 cases,nasolacrimal duct in 3 cases,foramina stylomastoideum in 2 cases and external auditory canal in 3 cases(a total of 35 foramen and tubes).When the tumor inva-ded the adjacent muscle bundles,spaces,nasal cavity,sinuses and basis crani,CT or MR showed the thickening of the surrounding tissues,with the density/signal abnormalities and obvious enhancement.When the tumor invaded the adjacent bone,cartilage,neural foramen and tube,CT displayed the thickening,thinning,or loss of the bone wall,as well as the enlargement of neural foramen and tube,wall thickening,and bone destruction.Conclusion CT and MR can show the imaging features of multiple small vesicles and ethmoid structures in the craniocervical ACC,as well as the invasion of adjacent tissues and the destruction of basis cranii,maxillofa-cial nerve foramen and tube,which are of great significance for the imaging diagnosis and surgical treatment of craniocervical ACC.

关 键 词：腺样囊性癌 神经孔 计算机体层成像 磁共振成像 

分 类 号：R739.91[医药卫生—肿瘤] R814.42[医药卫生—临床医学] R445.2