MSCT与MRI对蝶筛窦巨大黏液囊肿诊断价值的比较

Comparison of MSCT and MRI in the Diagnosis of Gaint Mucoceles in Ethmoid or Sphenoid Sinus

目的探讨蝶筛窦巨大黏液囊肿MSCT及MRI影像学特征,比较两者的临床应用价值。方法回顾性分析12例经病理证实的蝶筛窦巨大黏液囊肿影像资料,病例均行MSCT检查,6例行MRI检查,其中CT增强6例,MRI增强4例。结果囊肿多呈膨胀性生长,边界清楚,相应蝶筛窦壁受压、变薄、移位。CT平扫呈均匀软组织密度11例,稍低密度1例,增强后表现为囊肿周边黏膜环形强化2例,无强化4例;9例突入眶内引起不同程度内直肌、视神经及眼球受压,3例突入到颅内及鼻腔内。MRI T1WI呈低或稍低信号3例,稍高或高信号3例;T2WI均呈稍高或高信号,其中2例夹杂片状稍低信号。增强后3例见环形强化,1例无强化。结论 MSCT结合后处理重建能准确显示蝶筛窦解剖及病变毗邻结构改变,有利于临床医生术前选择准确的手术路径,MRI特征性的信号特征有利于定性诊断。MSCT对蝶筛窦巨大黏液囊肿的诊断价值优于MRI,两种检查方法相结合能为临床提供更准确的信息。

Objective To study the MSCT and MRI imaging characteristics of gaint mucoceles in ethmoid or sphenoid sinus and e- valuate the value. Methods The MSCT and MRI findings of giant mucoceles were retrospectively analyzed. All 12 cases underwent MSCT scan,6 cases also underwent MRI,of which contrast- enhanced MSCT was performed in 8 cases and contrast enhanced MRI in 4 cases. Results All 12 lesions showed dilatation and well- defined margins,and the involved bony walls were compressed and became thinning and displacement on all lesions. The main MSCT findings were heterogeneous soft tissue density masses. Peripheral sinus mueosa enhance- ment were showed in 2 cases after enhancement,and 9 lesions protruded into orbit and caused medial rectus muscle, optic nerve and eye- ball displaceed. Intracalvarium and nasal cavity were protruded in 3 cases. The main MRI findings were hyperintense signal on T1WI and T2WI. Circular enhancement were revealed on 4 cases after contrast - enhancing. Conclusion Anatomy and the adjacent structure change of lesions could displayed accurately on MSCT multiplanar reformation. It was helpful for the choice of treatment plan Characteristic signal on MRI was valuable for qualitative diagnosis. Diagnostic value of MSCT in ethmoid or sphenoid sinus was superior to MRI. Combination of two methods were able to provide more comprehensive information.