眼部筛窦横纹肌肉瘤CT及MRI影像学结果分析探讨

CT and MRI Manifestations and Radiological Analysis of Ethmoid Rhabdomyosarcoma

目的:提高对筛窦横纹肌肉瘤影像学表现及正确诊断的认识。方法:结合病理学及免疫组织化学检查结果,回顾分析4例筛窦横纹肌肉瘤的影像学表现。结果:病理学及免疫组织化学检查结果证实,4例患者中有3例为腺泡性横纹肌肉瘤,1例为胚胎性横纹肌肉瘤。CT和MRI影像学检查显示,病变以膨胀性生长为主,病变区域密度(信号)不均匀,增强扫描出现明显不均匀强化;病变组织对周围结构,如眼眶、鼻窦、鼻腔、前颅底等常有侵犯;骨质改变多以压迫性骨质吸收和溶骨型骨质吸收并存为主。结论:CT可以显示骨质的破坏程度和病变范围,MRI可以更清晰地显示病变侵犯的范围,而CT及MRI联合检查有助于准确判断筛窦横纹肌肉瘤的病变范围及侵犯范围。

Objecctive To understand the radiologieal manifestations and diagnosis of ethmoid sinus rhabdomyosarcoma. Methods Imaging manifestations of 4 ethmoid rhabdomyosarcoma patients were retrospectively analyzed, combined with the results by pathology and immunohistochemistry. Results The examinations of pathology and immunohistochemistry proved that there were 3 aeinar rhabdomyosareoma and one embryonal rhabdomyosarcoma, and CT and MRI revealed that the lesions were in expansive growth, uneven density （or signals）, and obvious heterogeneous enhancement of the lesion area with enhanced scanning. Tumor lesions invaded the surrounding tissues, including the nasal sinuses, nasal cavity and etc. Bone changes were mainly caused by oppressive and osteolytic bone resorption. Conclusion CT can reveal the area of pathologic lesions and bone resorptions, and MRI can show the invaded areas of the tumors. So, the combination of CT and MRI can define the areas of lesions and invaded areas of ethmoid sinus rhabdomyosarcoma.