鼻腔鼻窦小圆细胞肿瘤的CT和MRI影像表现及鉴别诊断价值分析  

The Analysis of CT and MRI Imaging Manifestations and Differential Diagnostic Value of Small Round Cell Tumors in Nasal Cavity and Paranasal Sinuses

作　　者：张瑞林 同斯平 Zhang Ruilin;Tong Siping(Ansai District People's Hospital,Yan'an City,Shaanxi Province,Yan'an Shaanxi 717400,China;Heyang County Traditional Chinese Medicine Hospital,Weinan Shaanxi 715300,China)

机构地区：[1]陕西省延安市安塞区人民医院,陕西延安717400 [2]合阳县中医医院,陕西渭南715300

出　　处：《医疗装备》2024年第23期22-25,共4页Medical Equipment

摘　　要：目的分析鼻腔鼻窦小圆细胞肿瘤(SRCT)的CT和MRI影像表现及鉴别诊断价值。方法回顾性分析2021年1月至2024年1月医院收治的120例SRCT患者的临床资料,所有患者均接受头部CT与MRI检查,分析2种检查方法的影像表现,以病理检查结果为金标准,分析CT和MRI对SRCT的诊断价值。结果CT图像多表现为形态不规则、分界不清、密度不均的软组织肿块,增强扫描呈中度至明显强化,部分强化不均。MRI的T_(1)WI多呈稍低或低信号,T_(2)WI多呈稍高信号,部分信号不均匀;增强扫描后,肿瘤常呈不均匀明显强化,血供丰富。术后病理检查结果显示良性85例,恶性35例。CT检查的灵敏度为57.14%,特异度为83.53%,准确度为75.83%;与病理检查结果的一致性中等(Kappa=0.410)。MRI检查灵敏度为82.86%,特异度为91.76%,准确度为89.17%;与病理检查结果的一致性较强(Kappa=0.740)。结论SRCT的CT和MRI检查的影像表现独特,CT可显示骨质结构和骨质破坏的情况;MRI对于软组织分辨率较高,能更清晰地显示肿瘤内部结构及周围组织的侵犯情况。临床诊断SRCT时,可首选MRI检查,并结合CT检查提高鉴别诊断准确度。Objective To analyze the value of CT and MRI imaging manifestations and differential diagnosis for small round cell tumors(SRCT)in nasal cavity and paranasal sinuses.Methods With the retrospective analysis of clinical data from 120 SRCT patients admitted to the hospital from January 2021 to January 2024,both head CT and MRI examinations were performed on all patients,and the imaging manifestations of two examination methods were analyzed.The diagnostic value of CT and MRI for SRCT was analyzed using pathological examination results as the gold standard.Results With a soft tissue mass shadow with irregular shape,unclear boundary,and uneven density as the main manifestation in CT images,moderate to significant enhancement,as well as partial uneven enhancement,were presented in the enhanced scan;Slightly low or low signal was presented on T_(1)WI of MRI,while slightly high signal was often present on T_(2)WI,with some uneven signal.After enhanced scanning,uneven and significant enhancement was often presented by tumors with abundant blood supply.Pathological examination showed that 85 cases were benign and 35 cases were malignant.The sensitivity,specificity,and accuracy of CT examination were 57.14%,83.53%,and 75.83%,respectively;The results showed moderate consistency with pathological examination(Kappa=0.410).The sensitivity,specificity,and accuracy of MRI examination were 82.86%,91.76%,and 89.17%,respectively;The results showed strong consistency with pathological examination(Kappa=0.740).Conclusions With unique imaging features in CT and MRI examinations for SRCT;CT can display bone structure and bone destruction;MRI with a high resolution for soft tissue can more clearly display the internal structure of tumors and the invasion for surrounding tissues.In the clinical diagnosis of SRCT,MRI examination can be preferred,and combined with CT examination to improve the accuracy of differential diagnosis.

关 键 词：鼻腔鼻窦小圆细胞肿瘤 CT MRI 影像表现 鉴别诊断 

分 类 号：R739.62[医药卫生—肿瘤]