CAJ | 학술논문

目的探讨鼻腔鼻窦神经鞘瘤的CT和MRI表现,并评价2种影像检查方法的临床应用价值.方法回顾性分析12例经组织学证实鼻腔鼻窦神经鞘瘤的影像资料,12例均做cT检查,10例做MR检查.结果 12例神经鞘瘤中良性11例,低度恶性1例;发生于鼻筛区4例,上颌窦3例,上颌窦、筛窦及蝶窦2例,上颌窦、鼻腔1例,蝶窦1例,后鼻孔1例;病变边界清楚,呈椭圆形4例,不规则形8例.CT表现:病变区轮廓扩大,相应鼻腔鼻窦骨质受压、变薄、移位,其中8例伴局部吸收,1例伴轻微侵蚀性破坏;平扫病变密度均匀10例,另2例其内可见低密度区,增强后2例病变显示不均匀强化.MRI表现:与脑实质比较,T1WI呈等信号,其中3例可见片状及结节状低信号,2例伴有片状高信号;T2WI呈不均匀等信号7例,稍高信号3例,其中2例伴有片状低信号;9例病变内可见点、片状高信号,其中6例伴有规整的结节状高信号,1例显示液-液面;增强后9例显示中度或显著不均匀强化,1例较均匀显著强化.2例行MR动态增强扫描,时间.信号强度曲线为平台型.6例伴有阻塞性鼻窦炎,T1WI为低信号,T2WI为高信号,增强后其内部不强化,边缘可见线状强化.MRI均清楚显示病变的范围和伴发的炎症.结论骨质变形、变薄、吸收和MR T2WI所示斑片、结节状高信号并且增强后无强化为该病特征性表现;CT和MR两种影像检查方法联合使用能够对该病的诊断、治疗提供更全面的信息.
목적 탐토비강비두신경초류적CT화MRI표현,병평개2충영상검사방법적림상응용개치.방법 회고성분석12례경조직학증실비강비두신경초류적영상자료,12례균주cT검사,10례주MR검사.결과 12례신경초류중량성11례,저도악성1례;발생우비사구4례,상합두3례,상합두、사두급접두2례,상합두、비강1례,접두1례,후비공1례;병변변계청초,정타원형4례,불규칙형8례.CT표현:병변구륜곽확대,상응비강비두골질수압、변박、이위,기중8례반국부흡수,1례반경미침식성파배;평소병변밀도균균10례,령2례기내가견저밀도구,증강후2례병변현시불균균강화.MRI표현:여뇌실질비교,T1WI정등신호,기중3례가견편상급결절상저신호,2례반유편상고신호;T2WI정불균균등신호7례,초고신호3례,기중2례반유편상저신호;9례병변내가견점、편상고신호,기중6례반유규정적결절상고신호,1례현시액-액면;증강후9례현시중도혹현저불균균강화,1례교균균현저강화.2례행MR동태증강소묘,시간.신호강도곡선위평태형.6례반유조새성비두염,T1WI위저신호,T2WI위고신호,증강후기내부불강화,변연가견선상강화.MRI균청초현시병변적범위화반발적염증.결론 골질변형、변박、흡수화MR T2WI소시반편、결절상고신호병차증강후무강화위해병특정성표현;CT화MR량충영상검사방법연합사용능구대해병적진단、치료제공경전면적신식.
Objective To study the CT and MRI findings of schwannoma in tIle sinonasal region and evaluate their clinical application.Methods All 12 cases of schwannoma locating in the sinonasal region were verified by pathology.r111e CT images in all 12 cases and MRI findings in 10 cases were analyzed retrospectively.Results Of the 12 cases of schwannoma in the sinonasal cavity.11 were benign and l was malignant.The tumors located in the nasoethmoid region in 4 cases.in the maxillary sinus in 3 cases and in the maxillary.ethmoid and sphenoid sinuses in 2 cases.The lesion of the remaining 3 cases involved maxillary sinus and hasal cavity,sphenoid sinus and choana respectively.The lesions with well-defined margin showed elliptic shape in 4 cases,irregular shape in 8 cases.On CT,the lesion resulted in dilatation of the affected sinonasal cavity with remodeling,thinning and displacement of the bony wall.In addition.local bony absorption was detected in 8 cases and bony destruction was found in 1 case.The lesions revealed homogeneous density in 10 cases and inhomogeneous in 2 on precontrast CT.Two cases showed heterogeneous enhancement on postcontrast CT. On MR T1WI,schwannoma in the sinonasal region demonstrated isointense signal compared to brain in 10 cases with patchy and nodular low signal intensity in 3 cases and patchy hish signal intensity in 2 cases.On T2 WI.the lesion showed heterogeneous isointense singal in 7 cases and slightly hyperintense signal in 3 cases.Stippled and patchy hyperintense signal was seen in 9 cases and well-defined and regular nedular high intense signal in 6 cases.Patchy low signal intensity was found in 2 cases corresponding to the high signal intensity on MR Tl WI.In addition,liquid-iquid level was identified in one case.The lesion displayed rooderate to marked inhomogeneous enhancement on contrast-enhanced MR images in 9 cases and marked homogeneous enhancement in one case.The time.intensity curve of dynamic contrast enhancement of MRI showed plateau type in 2 cases.In this group,the lesions were complicated with obstructive parasinusitis in 6 cases.which showed hypointense signal on MR T1 WI,hyperintense signal on T,WI and peripheral enhancement on postcontrast MRI.MRI showed the extent and other associated changes of the lesions more clearly compared to CT Conclusions Bone remodeling.thinning and absorption on CT and Patchy and noduhr high signal intensity on MR T2WI without postcontrast enhancement were typical manifestations of schwannoma in the sinonasal region.Combined findings of CT and MRI call provide more comprehensive information for the diagnosis and therapy.