鼻腔及鼻窦原发性恶性黑色素瘤CT和MRI的诊断价值

发布时间：2018-03-28 14:17

本文选题：黑色素瘤　切入点：鼻腔　出处：《医学影像学杂志》2016年08期

【摘要】：目的探讨CT和MR诊断鼻腔及鼻窦原发性恶性黑色素瘤的影像特点。方法回顾性分析经病理证实的11例鼻腔及鼻窦原发恶性黑色素瘤的CT和MRI影像表现。本组11例病变短径均1.5cm,CT检查11例,11例均行CT平扫;MRI扫描9例,均行平扫+DWI+增强扫描。重点观察病灶的数目、位置、形态、对周围结构侵犯及影像学特征。结果11例中,CT、MRI能准确反映病灶的位置、形态及邻近结构的累及情况。CT表现为单侧5例,双侧6例;肿瘤形态不规则,呈软组织密度,其内未见钙化及囊变,11例均侵犯周围组织;11例均有周围骨质破坏;9例患者主要MRI表现为9例形态均不规则;单侧5例,双侧4例;表现为混杂信号,T_1WI以等、低信号为主,其内可见斑片状高信号;T_2WI 5例以等低信号为主,4例以稍高信号为主,DWI均呈高信号,增强扫描呈轻中度不均匀强化,邻近周围组织均有侵犯。结论鼻腔及鼻窦原发性恶性黑色素瘤CT表现无特异性;MRI表现具有一定特异性。CT和MRI能很好地显示肿瘤的部位、与周围组织关系及邻近骨质破坏情况,为临床分期及手术方案制定提供帮助。
[Abstract]:Objective to investigate the imaging features of primary malignant melanoma in nasal cavity and paranasal sinus diagnosed by CT and Mr. Methods the CT and MRI findings of 11 cases of primary malignant melanoma in nasal cavity and paranasal sinus proved by pathology were retrospectively analyzed. Ct examination of 11 cases with short diameter 1.5 cm ~ (-1) CT scan was performed in 9 cases with plain CT scan, and 9 cases with MRI. The number, location, morphology, peripheral structure invasion and imaging features of the lesions were observed. Results in 11 cases, the location of lesions could be accurately reflected by Mr imaging. Ct findings were unilateral in 5 cases, bilateral in 6 cases, irregular in shape and density of soft tissue. In 11 cases without calcification and cystic degeneration, 11 cases had peripheral bone destruction and 9 cases had peripheral bone destruction. The main features of MRI were irregular in 9 cases, unilateral in 5 cases and bilateral in 4 cases. It was found that 5 cases had iso-low signal intensity on T2WI and 4 cases showed hyperintensity on DWI, and mild and moderate inhomogeneous enhancement on contrast enhancement. Conclusion the CT findings of primary malignant melanoma in nasal cavity and paranasal sinuses are nonspecific. Ct and MRI can well show the location of the tumor, the relationship with surrounding tissues and the destruction of adjacent bone. To provide assistance for clinical staging and surgical planning.
【作者单位】：浙江省丽水市中心医院放射科;
【分类号】：R739.62;R730.44;R445.2

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