摘要
目的探讨鼻腔鼻窦横纹肌肉瘤的CT和MRI表现,提高其诊断准确性。方法回顾性分析经组织学证实的18例鼻腔鼻窦横纹肌肉瘤患者的影像学资料。结果15例病变中心位于蝶筛区,3例位于上颌窦。CT表现:病变形态均不规则,边界不清楚,密度与邻近肌肉相近,相对比较均匀,邻近骨质呈溶骨性骨质破坏;增强后病变不均匀强化。MRI表现:与脑实质比较,病变T1WI呈略低信号7例,呈等信号3例;T2WI呈略高信号8例,呈等信号2例。病变信号欠均匀,7例病变内部可见小条状或小片状长T1长T2信号影,4例可见短T1长T2信号影。增强扫描,病变均呈中度不均匀强化。15例病变广泛侵犯周围结构,MRI可清楚显示病变侵犯的范围,其中眼眶受累8例,颅内受累8例,海绵窦受累5例,翼腭窝受累6例,鼻咽部受累3例。结论横纹肌肉瘤典型的MRI表现为稍长T1稍长T2信号,增强后中度强化。CT可以较好地显示骨质破坏,MRI能更清楚地显示病变的侵犯范围,两者结合可为该病诊断和临床治疗提供更全面的影像信息。
Objective To investigate CT and MRI findings of rhabdomyosarcoma in sinonasal cavity in order to improve the diagnostic accuracy. Methods CT and MRI data of 18 cases with rhabdomyosarcoma in sinonasal cavity confirmed histopathologically were analyzed retrospectively. Results Among the 18 patients, the lesions were centered in ethmoid-sphenoid region in 15 cases, in maxillary sinus in 3 cases. On CT, all lesions were irregular in shape, poorly marginated and had relatively homogenous isodensity to muscles. Adjacent bony structures showed osteolytic destruction. Postcontrast CT showed heterogeneous enhancement. On MR T1WI, the lesions showed slight hypointensity compared to brain in 7 casesand iso-intensity in 3 cases. On T2WI, the lesions showed slight hyperintensity in 8 cases and iso-intensity in 2 cases. The lesions were slightly heterogeneous in intensity. Small hypointense loci on T1WI and hyperintensity loci on T2WI in 7 cases as well as hyperintense loci on T1WI and T2WI in 4 cases were demonstrated. Postcontrast MR showed moderate inhomogeneous enhancement. 15 cases had extensive invasion of adjacent structures, MRI accurately showed the associated changes of the lesions. The lesion invaded the orbit, skull base, spongy sinus, pterygopalatine fossa, nasopharynx in 8, 8, 5, 6, 3 cases respectively. Conclusion Rhabdomyosarcoma is typically slightly hypointense on T1WI and hyperintense on T2WI with moderate enhancement. CT provides clear view of bone destruction. MRI can demonstrate optimally the invading extent of the lesions. Combined imaging commodities can provide more comprehensive information for diagnosis and therapy of rhabdomyosarcoma in sinonasal cavity.
出处
《中国医学影像技术》
CSCD
北大核心
2008年第3期366-369,共4页
Chinese Journal of Medical Imaging Technology
关键词
鼻腔
鼻窦
横纹肌肉瘤
体层摄影术
X线计算机
磁共振成像
Nasal cavity
Paranasal sinus
Rhabdomyosarcoma
Tomography, X-ray computed
Magnetic resonance imaging
