鼻腔鼻窦常见恶性肿瘤的CT和MRI影像学诊断

发布时间：2018-07-04 07:12

本文选题：鼻肿瘤 + 鼻窦肿瘤　；参考：《实用医学杂志》2017年06期

【摘要】：目的:分析鼻腔鼻窦常见恶性肿瘤的CT和MRI影像学特征,以提高其临床诊断的准确性。方法:对经病理证实的78例鼻腔鼻窦常见恶性肿瘤患者的临床资料进行回顾性分析,分析比较其CT和MRI的临床影像特征及其与临床诊断的符合率。结果:(1)鼻腔鼻窦恶性肿瘤缺乏特异性影像学表现,CT多表现为形态不规则、分界不清、密度不均的软组织肿块影,周围骨质常有破坏,常侵犯腔外的软组织,如眼眶、颅内;增强扫描呈中度-明显强化,部分强化不均强化。MRI多表现为T1WI呈稍低或低信号,T2WI呈稍高信号,部分信号不均匀,增强后呈不均匀明显强化。(2)CT、MRI对恶性肿瘤检出率相比,差异无统计学意义(P0.05),但CT与MRI联合应用,能提高恶性肿瘤的检出率(P0.05)。结论:鼻腔鼻窦恶性肿瘤影像学表现复杂,缺乏特异性,对于复杂性鼻腔鼻窦恶性肿瘤,建议增强CT和增强MRI联合应用,共同确定肿瘤性质、范围、与周围结构的关系,从而提高疾病的诊断。
[Abstract]:Objective: to analyze the CT and MRI imaging features of common malignant tumors of nasal cavity and paranasal sinus in order to improve the accuracy of clinical diagnosis. Methods: the clinical data of 78 patients with common malignant tumors of nasal cavity and paranasal sinuses proved by pathology were analyzed retrospectively. The clinical imaging features of CT and MRI and their coincidence rate with clinical diagnosis were analyzed and compared. Results: (1) in the absence of specific imaging findings of malignant tumors of nasal cavity and paranasal sinuses, CT was often characterized by irregular shape, unclear boundary, uneven density of soft tissue masses, destruction of surrounding bone and invasion of extraluminal soft tissue, such as orbit and intracranial. Contrast enhanced scan showed moderate and obvious enhancement, partial enhanced uneven enhancement. MRI showed slightly low or low signal intensity on T 1WI, slightly high signal on T 2WI, uneven signal intensity on T 2WI, and uneven enhancement after enhancement. (2) the detection rate of malignant tumor was higher than that of CT MRI. The difference was not statistically significant (P0.05), but the combined use of CT and MRI could improve the detection rate of malignant tumor (P0.05). Conclusion: the imaging features of malignant tumors of nasal cavity and paranasal sinus are complex and lack of specificity. For complex malignant tumors of nasal cavity and paranasal sinus, it is suggested that the combination of enhanced CT and enhanced MRI should be used to determine the nature, scope and relationship with the surrounding structure of the tumors. So as to improve the diagnosis of disease.
【作者单位】：重庆医科大学附属第一医院耳鼻咽喉科;
【基金】：国家临床重点专科建设项目经费资助(编号:卫办医政函[2012]649号) 重庆市卫生计生委科研项目(编号:2015HBRC004) 重庆市研究生科研创新项目(编号:CYS151210) 重庆市自然科学基金重点项目(编号:cstc2015jcyj B0028)
【分类号】：R739.62

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