鼻咽纤维血管瘤CT、MRI和DSA影像学分析

发布时间：2018-07-16 21:26

【摘要】：目的回顾性分析鼻咽纤维血管瘤术前CT、MRI、DSA影像学表现,总结其形态学和血供特点。方法94例鼻咽纤维血管瘤患者,根据有无既往治疗史分为原发组和术后继发组,分析影像征象,包括肿瘤发生部位、形态、轮廓边缘、CT密度、骨质侵蚀破坏、MRI T1WI信号强度、T2WI信号强度、T2WI信号均匀度、流空信号、增强后表现、DSA血供类型。结果 94例中发生于鼻咽后鼻孔区89例,鼻腔上颌窦5例。发生于鼻咽部89例(94.6%),鼻腔鼻窦5例(5.4%);圆形或椭圆形42例(44.7%),不规则形52例(55.3%);边缘光滑20例(21.2%),分叶状74例(78.8%)。70例CT检查中,密度均匀63例(90.0%),密度不均匀7例(10%),CT值在40~60 HU之间;局限性骨质侵蚀50例(71.4%),广泛性颅底骨质侵蚀16例(22.9%),无明确颅底骨质侵蚀4例(5.7%);74例MRI检查病例中,与脑灰质相比,T1WI等信号69例(93.2%),稍低信号5例(6.8%),信号均匀;T2WI高信号66例(89.1%),等信号8例(10.9%);T2WI信号均匀8例(10.9%),不均匀66例(89.1%),其中2例内部可以见到片状囊变信号区;MRI流空信号61例(82.4%),流空信号不明显13例(17.6%),MRI增强后明显不均匀强化49例(66.2%),均匀强化25例(33.8%);行DSA检查72例中,供血类型为单纯同侧颈外动脉分支供血39例(54.2%),颈外合并同侧或对侧颈内动脉分支供血33例(45.8%)。结论鼻咽纤维血管瘤影像学表现有特征性,以发生于鼻咽部、分叶状轮廓、CT密度均匀、局限性骨质侵蚀、MRI T1WI等信号、T2WI高信号且不均匀、流空信号、明显不均匀强化等征象为主,肿瘤大小、形态、供血类型3种征象,原发组和手术后复发组无特征。
[Abstract]:Objective to retrospectively analyze the imaging features of MRI DSA before nasopharyngeal angiofibroma and summarize its morphological and blood supply characteristics. Methods Ninety-four patients with nasopharyngeal fibroangioma were divided into primary group and secondary group according to the history of previous treatment. The imaging features, including tumor location, shape, contour margin and CT density, were analyzed. MRI T1WI signal intensity and T2WI signal intensity uniformity, flow empty signal intensity, enhanced DSA blood supply type. Results of 94 cases, 89 cases occurred in the nasopharynx posterior nostril area and 5 cases in the nasal cavity and maxillary sinus. In 89 cases (94.6%) of nasopharynx, 5 cases (5.4%) of nasal cavity and paranasal sinus, 42 cases (44.7%) of round or oval shape, 52 cases of irregular shape (55.3%), 20 cases (21.2%) of smooth margin, 74 cases (78.8%) of lobular shape, 70 cases of CT examination, the density was even in 63 cases (90.0%), the density was uneven in 7 cases (10%) in 4060 Hu. Local bone erosion was found in 50 cases (71.4%), extensive skull base erosion in 16 cases (22.9%), no definite skull base erosion in 4 cases (5.7%) and MRI examination in 74 cases. Compared with gray matter, 69 cases (93.2%) had isointense signal on T 1WI, 5 cases (6.8%) had low signal intensity, 66 cases (89.1%) had hyperintense signal on T2WI, 8 cases (10.9%) had homogeneous signal intensity on T 2WI, and 66 cases (89.1%) had abnormal signal intensity on T _ 2WI. There were 61 cases (82.4%) of signal, 13 cases (17.6%) of flow empty signal, 49 cases (66.2%) of inhomogeneous enhancement of MRI, 25 cases (33.8%) of homogeneous enhancement, 72 cases of which were examined by DSA. The type of blood supply was only ipsilateral external carotid artery supply in 39 cases (54.2%), external carotid artery with ipsilateral or contralateral internal carotid artery branch in 33 cases (45.8%). Conclusion the imaging features of nasopharyngeal fibroangioma are characterized by homogeneous CT density in nasopharynx with lobular contour, high signal intensity and uneven T2WI on MRI T1WI of localized bony erosion, flow empty signal and obvious heterogeneous enhancement. Tumor size, shape and blood supply type showed no characteristic in primary group and recurrence group.
【作者单位】：首都医科大学附属北京同仁医院放射科;北京市昌平区中西医结合医院放射科;首都医科大学附属北京友谊医院;
【分类号】：R739.63;R445.2;R730.44

【相似文献】