摘要
目的探讨鼻窦海绵状血管瘤的 CT 和 MRI 表现,提高其诊断准确性。方法回顾性分析30例经病理证实的鼻窦海绵状血管瘤患者的影像资料。结果发生于上颌窦者25例,前组筛窦3例,蝶窦2例。30例均可见病变向邻近的部位蔓延,压迫相应结构,但分界尚清楚,MRI 较 CT 显示更清楚。CT 表现为受累的鼻窦均有不同程度的扩大,窦壁骨质受压、变形,28例骨质不连续并形成缺损,以上颌窦内壁最常见(21例),残端骨质伴硬化8例,内可见软组织肿块影,边界清楚,密度不均匀,其中10例见静脉石影;16例增强后呈明显不均匀强化,内有散在、形态不一的明显强化区域。与脑组织比较病变在 MR T_1WI 呈低信号4例,中等信号14例;在 T_2WI 呈高信号16例,中等信号2例,但信号不均匀,其内可见形态及数量不一的低信号影;增强后病变呈显著不均匀强化,外观呈蜂窝状8例,斑驳状10例;8例动态增强扫描均显示渐进性强化。结论典型骨质改变加静脉石可提示该病诊断;MR T_2WI 不均匀高信号、渐进性强化、斑驳状或蜂窝状表现,也是诊断该病的特征性征象;联合使用 CT 和 MRI 可为该病诊断和治疗提供更准确、可靠的信息。
Objective To investigate the CT and MRI findings of cavernous hemangioma in paranasal sinus so as to promote the diagnostic accuracy. Methods All 30 cases of cavernous hemangioma in paranasal sinus were verified with pathological examinations. The CT and MRI findings were analyzed retrospectively. Results The lesions occurred in the maxillary sinus in 25 cases, in the anterior ethmoid sinus in 3 cases and in the sphenoid sinus in 2 cases. The lesions extended and compressed adjacent structures. MRI showed the extent and the associated changes of the lesions more clearly compared to CT. On CT, all the involved paranasal sinuses invariably expanded. The bony walls of paranasal sinuses were compressed and remodeled with focal defect in 28 cases, mostly in the medial wall of the maxillary sinus （21 cases）. Bony scelerosis of the residual walls of paranasal sinus were found in 8 cases. The lesions demonstrated well-defined margin and heterogeneous density with phlebolith in 10 cases. Postcontrast CT showed marked inhomogeneous enhancement in 16 cases. On MR TIWI, canernous hemangioma showed hypointense signal compared to brain in 4 cases and isointense signal in 14 cases. On T2WI, the lesions revealed heterogeneous hyperintense singal in 16 cases and isointense signal in 2 cases with multiple hypointense foci. Postcontrast MR imaging demonstrated marked inhomogeneous enhancement in these cases, honeycomb-like appearance in 8 cases and variegated appearance in 10 cases. The feature of progressive enhancement was found on dynamic contrast enhancement of MR] in 8 cases. Conclusions The characteristic bony change together with phlebolith can suggest the diagnosis of cavernous hemangioma in paranasal sinus on CT. The heterogeneous hyperintense singal on MR T2WI, progressive enhancement and honeycomb-like or variegated appearance on postcontrast MRI were also the characteristic findings of cavernous hemangioma in paranasal sinus. Combination of CT and MRI findings can provide more accurate information for the diagnosis and therapy of cavernous hemangioma in paranasal sinus.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2007年第11期1153-1157,共5页
Chinese Journal of Radiology
关键词
血管瘤
海绵状
鼻窦疾病
体层摄影术
X线计算机
磁共振成像
Hemangioma, cavernous
Paranasal sinus diseases
Tomography, X-ray computed
Magnetic resonance imaging
