鼻腔鼻窦Rosai-Dorfman病的CT和MRI影像学表现  

CT and MRI manifestations of Rosai-Dorfman disease in nasal cavity and paranasal sinus

作　　者：王露茜 张利芬 牛悦 陈伟 肖涵予 张旖吟 沙炎 Wang Luxi;Zhang Lifen;Niu Yue;Chen Wei;Xiao Hanyu;Zhang Yiyin;Sha Yan(Department of Radiology,Eye&ENT Hospital of Fudan University,Shanghai Institute of Medical Imaging,Shanghai 200031,China;Department of Pathology,Eye&ENT Hospital of Fudan University,Shanghai 200031,China;Department of Radiology,Eye&ENT Hospital of Fudan University,Shanghai 200031,China)

机构地区：[1]上海市影像医学研究所、复旦大学附属眼耳鼻喉科医院放射科,上海200031 [2]复旦大学附属眼耳鼻喉科医院病理科,上海200031 [3]复旦大学附属眼耳鼻喉科医院放射科,上海200031

出　　处：《中华放射学杂志》2025年第3期293-298,共6页Chinese Journal of Radiology

摘　　要：目的探讨鼻腔鼻窦Rosai-Dorfman病(RDD)的CT和MRI影像学特点。方法该研究为横断面研究,回顾性分析2007年7月至2023年8月于复旦大学附属眼耳鼻喉科医院经组织病理学证实的鼻腔鼻窦RDD患者的CT和MRI资料。共23例,男9例、女14例,年龄(44±16)岁。记录病灶位置、范围、密度与信号、骨质情况、强化程度、周围淋巴结及其他部位异常病灶情况。接受扩散加权成像(DWI)的患者测量病灶表观扩散系数(ADC)值。结果23例患者中,20例为双侧鼻腔鼻窦受累,3例为单侧病变。9例患者病变局限于鼻腔鼻窦,14例患者病灶向周围浸润生长,累及眼眶6例、鼻泪管9例、前颅底3例、鼻背皮下2例、硬腭1例。2例伴喉部、声门下气管后壁软组织病变,1例伴颅内弥漫性病变。10例伴有淋巴结肿大。RDD病变在CT平扫(20例)均呈等密度,增强(17例)后表现为轻度强化3例、中等强化7例、明显强化7例。20例患者中有19例在CT上发现骨质改变,骨质破坏伴骨质增生14例,轻度骨质破坏5例。14例接受MRI检查的患者中,病变在T 1WI上均呈等信号,在T 2WI上9例为等信号、4例为稍低信号、1例为稍高信号。增强后呈中等至明显强化,强化较均匀,无囊变或坏死。11例接受DWI,病变扩散明显受限,ADC值为(0.66±0.08)×10^(-3)mm^(2)/s。结论鼻腔鼻窦RDD的CT和MRI影像特点为鼻腔鼻窦双侧病变,伴有骨质增生硬化,T 2WI呈等低信号,可累及邻近组织,可伴有咽后、颈部淋巴结肿大。ObjectiveTo explore the CT and MRI features of Rosai-Dorfman disease(RDD)in nasal cavity and paranasal sinus.MethodsThe study was a cross-sectional study.From July 2007 to August 2023,the imaging findings of 23 patients with pathologically confirmed sinonasal RDD were retrospectively analyzed in the Eye&ENT Hospital of Fudan University.Among 23 patients,there were nine males and 14 females with 44±16 years old.Imaging features including tumor location,the extent,density,signal,enhancement pattern of tumors,bone change,abnormal lesions in peripheral lymph nodes and other regions were recorded.The apparent diffusion coefficient(ADC)value of lesions in patients performed diffusion weighted imaging(DWI)were measured.ResultsFor the 23 cases,totally 20 patients showed bilateral sinonasal involvement and three patients had unilateral lesions.Totally nine patients had lesions confined to the nasal cavity and paranasal sinuses,and 14 patients had lesions with extrasinonasal invasion,including orbit(6 cases),nasolacrimal duct(9 cases),anterior skull base(3 cases),nasal dorsum subcutaneous tissue(2 cases)and hard palate(1 case).Soft tissue lesions on the posterior wall of the subglottic trachea were found in 2 cases and intracranial lesions were found in 1 case.Totally 10 patients were accompanied by lymph nodes enlargement.The lesions showed isodense on all 20 non-contrast enhanced CT images,and mild enhancement in three cases,moderate enhancement in seven cases and significant enhancement in seven cases on CT enhancement images.Bone changes were found in 19 of 20 patients on CT,showing mild bone destruction in five cases and bone destruction with hyperplasia in 14 cases.The lesions showed isointense on T 1WI in all 14 cases.The lesions were graded as isointense in nine cases,hypointense in four cases and hyperintense in one case on T 2WI.The lesions displayed moderate to obvious homogeneous enhancement on enhanced MRI.The lesions showed significant diffusion limitation and ADC value was(0.66±0.08)×10^(-3)mm^(2)/s in 11

关 键 词：鼻腔 鼻窦 体层摄影术 X线计算机 磁共振成像 ROSAI-DORFMAN病 

分 类 号：R73[医药卫生—肿瘤]