中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2012年
7期
615-618
,共4页
张青%朱庆强%吴晶涛%王振常%王中秋%鲜军舫%陈文新%刘中林%王守安%杨本涛%姜伦%燕飞%李书玲
張青%硃慶彊%吳晶濤%王振常%王中鞦%鮮軍舫%陳文新%劉中林%王守安%楊本濤%薑倫%燕飛%李書玲
장청%주경강%오정도%왕진상%왕중추%선군방%진문신%류중림%왕수안%양본도%강륜%연비%리서령
鼻窦%癌,神经内分泌%体层摄影术,X线计算机%磁共振成像
鼻竇%癌,神經內分泌%體層攝影術,X線計算機%磁共振成像
비두%암,신경내분비%체층섭영술,X선계산궤%자공진성상
Paranasal sinuses% Carcinoma,neuroendocrine% Tomography,X-ray computed%Magnetic resonance imaging
目的 探讨鼻窦神经内分泌癌的CT和MRI的特征性表现.方法 回顾性分析经病理证实的10例鼻窦神经内分泌癌的影像资料及临床资料,男5例、女5例;年龄27 ～ 57岁,平均(48±9)岁.患者均行MR平扫及增强检查,9例同时行CT检查.结果 病变主体位于筛窦6例次、蝶窦5例次、上颌窦2例次,位于蝶窦者病变对称.典型类癌1例、不典型类癌1例、神经内分泌癌8例(其中大细胞型3例、小细胞型5例).6例直径＞3 cm,呈不规则分叶状;4例直径＜3 cm,呈椭圆形.CT表现:1例呈等密度;4例肿瘤内见斑点、线条状高密度影,呈等高密度;4例有线环状或葡萄状低密度影.1例典型类癌呈骨质硬化、压迫吸收表现,余8例呈虫蚀状骨质破坏.MRI:10例均表现为T1WI等信号;T2WI4例为等信号,6例以等信号为主,混杂少量线条、斑片、葡萄状高信号.增强扫描7例呈轻中度不均匀强化,3例明显强化.2例MRI动态增强时间-信号强度曲线为平台型.肿瘤广泛累及邻近结构,鼻腔受累9例次,侵犯眼眶7例次,翼腭窝4例次,筛窦、蝶骨和颞下窝各3例次,枕骨斜坡、海绵窦、颈内动脉管和视神经管各2例次,前颅窝底、颈静脉孔、岩尖、脑膜、颞窝、鼻咽腔及咽旁间隙各1例次.结论 鼻窦神经内分泌癌的CT骨质改变依病理学分型不同有所差别,MRI可准确显示肿瘤累及范围,两者联合应用可对其诊断及治疗提供更全面的信息.
目的 探討鼻竇神經內分泌癌的CT和MRI的特徵性錶現.方法 迴顧性分析經病理證實的10例鼻竇神經內分泌癌的影像資料及臨床資料,男5例、女5例;年齡27 ～ 57歲,平均(48±9)歲.患者均行MR平掃及增彊檢查,9例同時行CT檢查.結果 病變主體位于篩竇6例次、蝶竇5例次、上頜竇2例次,位于蝶竇者病變對稱.典型類癌1例、不典型類癌1例、神經內分泌癌8例(其中大細胞型3例、小細胞型5例).6例直徑＞3 cm,呈不規則分葉狀;4例直徑＜3 cm,呈橢圓形.CT錶現:1例呈等密度;4例腫瘤內見斑點、線條狀高密度影,呈等高密度;4例有線環狀或葡萄狀低密度影.1例典型類癌呈骨質硬化、壓迫吸收錶現,餘8例呈蟲蝕狀骨質破壞.MRI:10例均錶現為T1WI等信號;T2WI4例為等信號,6例以等信號為主,混雜少量線條、斑片、葡萄狀高信號.增彊掃描7例呈輕中度不均勻彊化,3例明顯彊化.2例MRI動態增彊時間-信號彊度麯線為平檯型.腫瘤廣汎纍及鄰近結構,鼻腔受纍9例次,侵犯眼眶7例次,翼腭窩4例次,篩竇、蝶骨和顳下窩各3例次,枕骨斜坡、海綿竇、頸內動脈管和視神經管各2例次,前顱窩底、頸靜脈孔、巖尖、腦膜、顳窩、鼻嚥腔及嚥徬間隙各1例次.結論 鼻竇神經內分泌癌的CT骨質改變依病理學分型不同有所差彆,MRI可準確顯示腫瘤纍及範圍,兩者聯閤應用可對其診斷及治療提供更全麵的信息.
목적 탐토비두신경내분비암적CT화MRI적특정성표현.방법 회고성분석경병리증실적10례비두신경내분비암적영상자료급림상자료,남5례、녀5례;년령27 ～ 57세,평균(48±9)세.환자균행MR평소급증강검사,9례동시행CT검사.결과 병변주체위우사두6례차、접두5례차、상합두2례차,위우접두자병변대칭.전형유암1례、불전형유암1례、신경내분비암8례(기중대세포형3례、소세포형5례).6례직경＞3 cm,정불규칙분협상;4례직경＜3 cm,정타원형.CT표현:1례정등밀도;4례종류내견반점、선조상고밀도영,정등고밀도;4례유선배상혹포도상저밀도영.1례전형유암정골질경화、압박흡수표현,여8례정충식상골질파배.MRI:10례균표현위T1WI등신호;T2WI4례위등신호,6례이등신호위주,혼잡소량선조、반편、포도상고신호.증강소묘7례정경중도불균균강화,3례명현강화.2례MRI동태증강시간-신호강도곡선위평태형.종류엄범루급린근결구,비강수루9례차,침범안광7례차,익악와4례차,사두、접골화섭하와각3례차,침골사파、해면두、경내동맥관화시신경관각2례차,전로와저、경정맥공、암첨、뇌막、섭와、비인강급인방간극각1례차.결론 비두신경내분비암적CT골질개변의병이학분형불동유소차별,MRI가준학현시종류루급범위,량자연합응용가대기진단급치료제공경전면적신식.
Objective To investigate the CT and MRI characteristic features of neuroendocrine carcinoma in paranasal sinuses.Methods CT and MRI findings of 10 patients with proved neuroendocrine carcinoma by pathology were retrospectively reviewed. All patients underwent plain and enhanced MRI scanning,and 9 patients also underwent CT manning.Results There were 5 males and 5 females with mean age of (48 ± 9 ) years old,ranging from 27 to 57 years.The treatment time after symptoms onset ranged from 1 to 4 months,with the median of 2 months.Clinical symptoms were headache and vision loss,hyposmia and yellow nasal discharge,and exophthalmos.The lesions were located in the ethmoidal sinus ( n =6 ),maxillary sinus ( n =2),and bilateral sphenoid sinus ( n =5 ).The lesions were symmetrical in the sphenoid sinus.Pathology type included typical carcinoid tumor ( n =1 ),atypical carcinoid ( n =1 ),and neuroendocrine carcinoma not otherwise specified ( n =8 ). Immunohistochemical staining showed that neurospecific enolase,synaptophysin,cytokeratin and P53 were all positive.On CT images,lesions showed isointensity (n =1 ),iso- to hypointense (n =4 ),and iso- to hyperintense (n =4 ) with hypointense or hyperintense spots.Bone changes included bony absorption and sclerosis ( n =1 ) with a clear margin in typical carcinoid tumor,and moth-eaten bone destruction in other 8 cases( n =8).The lesions were isointense on T1-weighted images,and isointense (n =4) or mixed iso- to hyperintense on T2-weighted images (n =6).Lesions showed mild to medium heterogeneous enhancement ( n =7 ) or marked enhancement ( n =3 )on gadolinium-enhanced images.Time-signal intensity curve ( TIC ) showed plateau type in 2 cases.The aggressive nature of the tumors was demonstrated by invasion of adjacent structures,involvement of nasal cavity( n =9 ),orbits ( n =7 ),pterygopalatine fossa ( n =4 ),ethmoidalsinus and sphenoid ( n =3 ),clivus ossis occipitalis(n =2),cavernous sinus and internal carotid canal(n =2),optic canal(n =2),jugular fossa ( n =1 ),anterior fossa ( n =1 ),apex partis petrosae ossis temporalis ( n =1 ),meninges ( n =1 ),temporal fossa and infratemporal fossa ( n =1 ),pharyngonasal cavity and parapharyngeal space ( n =1 ).Conclusions There are different CT features in different pathological types of neuroendocrine carcinoma of the paranasal sinuses,and MRI can demonstrate the invasive extent accurately. CT combined MRI can provide more comprehensive information in the diagnosis and therapy.
