上颌窦出血性息肉的影像学分析

发布时间：2018-01-20 03:38

本文关键词： 鼻窦息肉体层摄影术 X线计算机磁共振成像　出处：《临床耳鼻咽喉头颈外科杂志》2017年15期 　论文类型：期刊论文

【摘要】：目的:探讨上颌窦出血性息肉的CT、MRI表现,总结影像学特点,为临床诊断提供帮助。方法:回顾性分析27例经手术病理证实的上颌窦出血性息肉CT、MRI影像学资料。针对病变部位、形状、范围,窦壁骨质改变,病变边缘及周围结构情况,病变密度或信号,各期增强扫描的强化方式、幅度及范围进行统计分析。结果:27例患者均为单侧发病。均行CT平扫,其中9例行双期动态增强CT检查,11例行MRI检查,其中6例行MRI增强检查。CT平扫见单侧上颌窦充满等低混杂密度影并累及鼻腔,上颌窦不均匀膨大变形,伴局部骨质吸收破坏27例,但未侵犯邻近结构,CT增强扫描病变内见点片状血管样显著强化及进行性强化。MRI能清楚区分病变及阻塞性鼻窦炎,病变均形态不规则,呈混杂信号,T1WI主要为中等信号8例、稍低信号3例,混杂少量高信号;T2WI呈高低混杂信号,边缘见不规则低信号环。增强呈多发结节状、斑片状不均匀明显强化。结论:上颌窦出血性息肉CT显示实变上颌窦不规则膨大变形伴骨质压迫吸收对本病有一定提示作用,血管样显著强化及进行性强化是本病的特征性增强CT表现,MRI具有非常典型的影像学表现,T2WI呈高低混杂信号和低信号环,增强呈多发结节状、斑片状不均匀明显强化,能清楚地显示病变与周围软组织无侵犯征象。具有较好的诊断价值。术前CT和MRI检查对该病的术前诊断有重要意义。
[Abstract]:Objective: to investigate the CT MRI features of hemorrhagic polyps of maxillary sinus and summarize the imaging features. Methods: the imaging data of 27 cases of maxillary sinus hemorrhagic polyp confirmed by surgery and pathology were analyzed retrospectively, according to the location, shape, range and bone changes of sinus wall. The edge and surrounding structure of the lesion, the density or signal of the lesion, the enhancement mode, the amplitude and the range of each phase of enhanced scan were statistically analyzed. Results all the 27 cases of disease were unilateral and all underwent plain CT scan. Among them, 9 cases were examined by dual phase dynamic contrast-enhanced CT and 11 cases by MRI, among them, 6 cases were examined by MRI. Ct plain scan showed that unilateral maxillary sinus was filled with low mixed density and involved nasal cavity. The maxillary sinus was inhomogeneous enlarged and deformed, accompanied by local bone resorption and destruction in 27 cases, but did not invade the adjacent structure. Enhanced CT scan showed patchy enhancement and progressive enhancement. MRI could clearly distinguish the lesions from obstructive sinusitis. The lesions were irregular in shape and showed mixed signal. T1WI mainly showed moderate signal intensity in 8 cases, slightly low signal intensity in 3 cases, mixed with a small amount of high signal intensity. T2WI showed high and low mixed signal intensity, irregular hypointensity ring at the edge and multiple nodular enhancement. Conclusion: Ct of hemorrhagic polyp of maxillary sinus shows irregular enlargement of maxillary sinus with bone compression and absorption. Vascular-like enhancement and progressive enhancement are the characteristic CT features of this disease. MRI is a typical imaging manifestation with high and low signal intensity and low signal loop on T _ 2WI and multiple nodules on contrast enhancement. The patchy uneven enhancement can clearly show the lesion and the surrounding soft tissue without the signs of invasion. It has good diagnostic value. Preoperative CT and MRI are important for the preoperative diagnosis of the disease.
【作者单位】：中国医科大学附属盛京医院耳鼻咽喉头颈外科;
【分类号】：R445.2;R765;R816.96
【正文快照】： 临床耳鼻咽喉科杂志,1998,12(2):90-91.[10]HOSEMANN W,SCOTTI O,BENTZIEN S.Evalua-tion of telescopes and forceps for endoscopic tran-snasal surgery on the maxillary sinus[J].Am J Rhi-nol,2003,17:311-316.[11]古庆家,李静娴,樊建刚,等.单侧上颌窦良性占位性病变手

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