鼻腔NK/T细胞淋巴瘤的CT和MRI表现

Diagnosis of nasal NK/T-cell lymphoma with CT and MRI

目的:分析和总结鼻腔原发NK/T细胞淋巴瘤的CT和MRI表现,探讨其影像学特征,以提高诊断的准确性。方法:回顾性分析25例经病理证实的鼻腔原发NK/T细胞淋巴瘤的CT和MRI影像资料。结果:原发肿瘤位于单侧鼻腔10例,双侧鼻腔8例,发生在鼻后孔7例。肿瘤侵犯周围结构包括鼻旁窦受累11例,鼻咽12例,鼻唇沟9例,口咽11例,面部软组织6例,前颅窝2例,中颅窝1例,翼腭窝1例。骨质破坏21例,包括副鼻窦壁破坏9例,鼻甲15例,筛骨、眶板12例,眶底10例,斜坡1例。颈部淋巴结肿大5例。CT平扫,25例均呈均匀等密度,18例行增强扫描后,均呈轻到中度强化。MRI扫描,25例T1WI呈等信号,T2WI呈稍高信号,其中3例信号欠均匀,21例行增强扫描后,均呈轻到中度强化,其中4例强化欠均匀。结论:鼻腔NK/T淋巴瘤的CT和MRI表现具有一定的特征性,但仍需通过病理学确诊。

Objective：To analyse the CT and MR imaging findings of primary nasal NK/T-cell lymphoma to investigate corresponding imaging features and improve the diagnostic accuracy.Methods：25 pathologically confirmed nasal NK/T-cell lymphoma patients were included in this study in which CT and MRI images were analysed retrospectively.Results：10 cases of primary tumor were located in the unilateral nasal cavity,8 in bilateral nasal cavity and 7 in choana.Destructions of adjacent structure included tumor invasion of paranasal sinuses（n=11）,nasopharynx（n=12）,nasal labial fold（n=9）,oropharynx（n=11）,facial soft tissue（n=6）,anterior cranial fossa（n=2）,middle cranial fossa（n=1）,and pterygopalatine fossa（n=1）.Bony destructions were demonstrated in 21 cases,involving the sinus bony wall（n=9）,nasal turbinate（n=15）,lamina papyracea（n=12）,orbital floor（n=10）,and clivus（n=1）.Lymph node enlargement were detected in 5 cases.On CT,25 cases showed homogeneous and intermediate density,18 cases with intravenous contrast medium administration showed mild-moderate enhancement.On MRI,25 cases showed isointensity on T1WI and slightly higher signal intensity on T2WI,3 cases of them showed heterogeneous intensity,21 cases with intravenous contrast medium administration showed mild-moderate enhancement,4 cases of them showed heterogenous enhancement.Conclusion：Definite features were demonstrated on CT and MRI images of primary nasal Nk/T-cell lymphoma,however,the pathological confirmations are requisite in the final diagnosis.