鼻腔鼻窦纤维血管瘤的CT、MRI表现及鉴别诊断

CT and MRI findings as well as the differential diagnosis of nasal sinus angiofibroma

目的分析鼻腔鼻窦纤维血管瘤的影像学表现,探讨影像学对该部分肿瘤的诊断及鉴别诊断,减少误诊。方法回顾性分析经手术病理证实的10例鼻腔鼻窦纤维血管瘤的临床和影像资料。术前常规平扫及增强扫描,对照分析影像表现和组织病理表现。结果鼻腔鼻窦纤维血管瘤中老年多发,临床表现可为鼻塞、涕中带血或鼻出血。肿瘤可有伪膜,肿瘤内可有出血、囊变、钙化,增强扫描多有较明显强化,部分可见多发小斑片状明显强化,病灶较大时可压迫周边骨质引起吸收破坏。结论鼻腔鼻窦纤维血管瘤少见,误诊率高,但影像学有一定特征性,有重要的诊断及鉴别诊断价值。

Objective To analyze the imaging of nasal sinus angiofibroma（AF）,and to discuss the diagnosis and differential diagnosis of tumors in order to avoid misdiagnosis.Methods The CT and MRI findings of nasal sinus AF in 10 patients proved by operation and pathology were retrospectively reviewed.The preoperative routine scan and enhanced scan were performed.The imaging findings and histopathological manifestation were comparatively analyzed.Results Nasal sinus AF was prone to occur in people over 40 years old,with symptoms like stuffy nose,nosebleed or nasal discharge accompanied with blood.The tumor has pseudomembrane,necrosis,cystic degeneration and hemorrhage within it.Enhanced scan showed significant enhancement mostly,and part of it showed multiple patchable enhancement.When the tumor was larger,it could compress the bone around and result in damage of absorption.Conclusion Nasal sinus AF was uncommon in clinic and often with high misdiagnosis rate.Its imaging has certain characteristics,which has important diagnostic and differential diagnostic value.