咀嚼间隙疾病的MRI和CT诊断

MRI and CT Diagnosis of Diseases in Masticator Space

目的：评价ＭＲＩ和ＣＴ对咀嚼间隙病变的诊断价值。材料和方法：回顾性分析４２例咀嚼间隙病变的ＭＲＩ和ＣＴ表现。除５例感染经抗炎治疗好转外，均经手术病理证实。结果：５例蜂窝织炎病变弥漫，累及间隙内脂肪、咀嚼肌和周围间隙及其皮下脂肪，无明确肿块和骨质破坏，ＭＲＩ和ＣＴ均具特征，１例炎性肉芽肿有明确肿块和骨质破坏，术前误诊；５例原发性肿瘤均有明确肿块、间隙内脂肪受压消失、翼内肌受压向后内移位和骨质受压或破坏，除软骨瘤外均缺乏组织学特征；３１例累及咀嚼间隙的继发性肿瘤ＭＲＩ和ＣＴ均能显示其侵入的途径和范围。结论：ＭＲＩ和ＣＴ对显示病变的范围、鉴别感染类型、判断肿瘤位置、性质和来源具有重要价值。

Purpose:To evaluate MRI and CT diagnosis in lesions of masticator space.Materials and Methods:MRI and CT findings of 42 cases with lesions invading masticator space were retrospectively analysed and proved by surgery and pathology except 5 cases with infections of masticator space.Results:MRI and CT Characteristics of cellulitis were diffuse and extensive signal abnomalities and increased attenuations of fatty tissues,adjacent spaces with secondary invasion of head and neck without mass and bone destructions.Primary tumors showed a larger mass with obliteration of fat planes in masticator spaces,bone destruction or compression and pushing medial pterygoid musscls posteriorly and medially.Histologic features of the tumors were not found except for chondroma.The routes of secondary tumors invading masticator spaces were seen in MRI and CT.Conclusion:MRI and CT can provide useful infomations about defining the types of infections and the extent,nature and origin of tumors important for determining clinical treatment.