CAJ | 학술논문

目的分析鼻腔鼻窦转移瘤的影像表现。方法回顾性分析经病理确诊为鼻腔鼻窦转移瘤患者10例，共12个肿块，原发肿瘤分别为肾透明细胞癌6例、肺腺癌2例、结肠腺癌和肝细胞癌各1例。所有患者均行CT及MRI平扫，其中9例行MRI增强扫描，5例行MRI动态增强扫描。对病灶的部位、骨质改变、形态、密度和信号特点以及强化特征进行观察。结果转移瘤位于蝶筛区3个、筛窦2个、上颌窦2个、鼻腔2个、额筛区2个、蝶窦1个。12个转移瘤均有骨质破坏，1例合并肿瘤骨形成。CT显示10个转移瘤呈等密度、1个呈等高混杂密度、1个呈等低混杂密度。MRI表现为T1WI与脑灰质相比呈等信号9个、等低混杂信号3个；T2WI呈等高混杂信号11个、均匀低信号1个。增强扫描肿瘤均呈明显不均匀强化，5例行动态增强扫描的时间-信号曲线呈流出型4例、平台型1例。结论鼻腔鼻窦转移瘤最常见的原发肿瘤是肾癌。典型影像表现是位于筛窦并累及周围多个窦腔的富血供软组织肿块伴明显骨质破坏。
목적분석비강비두전이류적영상표현。방법회고성분석경병리학진위비강비두전이류환자10례，공12개종괴，원발종류분별위신투명세포암6례、폐선암2례、결장선암화간세포암각1례。소유환자균행CT급MRI평소，기중9례행MRI증강소묘，5례행MRI동태증강소묘。대병조적부위、골질개변、형태、밀도화신호특점이급강화특정진행관찰。결과전이류위우접사구3개、사두2개、상합두2개、비강2개、액사구2개、접두1개。12개전이류균유골질파배，1례합병종류골형성。CT현시10개전이류정등밀도、1개정등고혼잡밀도、1개정등저혼잡밀도。MRI표현위T1WI여뇌회질상비정등신호9개、등저혼잡신호3개；T2WI정등고혼잡신호11개、균균저신호1개。증강소묘종류균정명현불균균강화，5례행동태증강소묘적시간-신호곡선정류출형4례、평태형1례。결론비강비두전이류최상견적원발종류시신암。전형영상표현시위우사두병루급주위다개두강적부혈공연조직종괴반명현골질파배。
Objective To investigate the imaging manifestations of metastasis in the nasal cavity and paranasal sinuses. Methods Twelve lesions of 10 patients with pathologically proved metastasis were retrospectively reviewed, including 6 renal clear cell carcinoma, 2 pulmonary adenocarcinoma, 1 colorectal carcinoma and 1 hepatic carcinoma. All the patients underwent CT and MRI scan.Among them,9 patients had contrast enhanced MRI scan and 5 patients had dynamic contrast-enhenced MRI as well. The location, bone changes, shape,margin,density,signal intensity, and enhancement characteristics of the lesions were observed. Results The metastasis involved spheno-ethmoid area(n=3), ethmoid sinus (n=2), maxillary sinus (n=2), nasal cavity(n=2), fronto-ethmoid area(n=2) and sphenoid sinus (n=1). All 12 metastatic lesions demonstrated bone destruction with tumor bone formation in 1 lesion. The CT displayed 10 metastases showed equal density, one mixed density was high, another form of low-density mixed. MR imaging showed equal signal in 9 lesions, while low-mixed signal in 3 lesions on T1WI compared with grey matter were found. On T2WI, 11 lesions showed high mixed signal and homogeneous low signal in 1 lesion. All 12 lesions demonstrated markedly heterogenous enhancement after intravenous administration of contrast media. Of 5 cases with dynamic contrast-enhanced MRI scanning, 4 lesions demonstrated wash-out time-signal intensity curve (TIC) pattern and 1 lesion demonstrated plateau pattern. Conclusions Renal carcinoma is the most common primary tumor for nasal cavity and paranasal sinuses metastasis. A typical imaging finding is located in the ethmoid sinuses, the soft tissue mass surrounded with rich blood supply multiple sinuses and significant bone destruction.