鼻腔鼻窦胚胎型横纹肌肉瘤的MRI表现及临床价值研究

Appearance and Clinical Value of MRI in Sinonasal Embryonal Rhabdomyosarcoma

目的探讨鼻腔鼻窦胚胎型横纹肌肉瘤磁共振表现及临床价值。方法选取我院于2009年4月至2013年4月收治的11例经临床病理确诊的鼻腔鼻窦胚胎型横纹肌肉瘤患者,对其临床资料、病理资料以及磁共振资料进行回顾性分析。结果本组所选取的11例患者,其中8例病变于筛窦处,3例病变部位于鼻中隔处,均累及多个鼻窦、前颅窝底脑膜以及眼眶。其中T1W1图像呈不均性低信号者7例;呈均匀等信号者2例;以均匀等信号为主,其内见散在小片状、小点状高信号者2例。T2W1图像主要表现为稍高信号者8例,呈混杂片状分布的低信号者3例;其中以稍高信号为主,其间见散在片状、小点状更高信号者2例。增强扫描后,7例患者肿瘤边界显示清晰,11例肿瘤病灶区均呈不均匀的明显强化。肿瘤区可见骨质破坏和骨质推压改变。结论 MRI不仅准确的显示ERMS的具体部位、范围,而且能基本反应病变内部组织成分及其变化情况,对ERMS的诊断、治疗和判断预后有着重要临床意义。

Objective To investigate the appearance and clinical value of MRI in the diagnosis of embryonal rhabdomyosarcoma in nasal cavity and paranasal sinuses. Methods A hospital in April 2009 to April 2013 were 11 cases of Patients with nasal sinuses embryonal rhabdomyosarcoma, to retrbspective analysis of clinical data, pathological data and MRI. Results All 11 cases involved multilocation. Among them, 8 cases mainly located in the ethmoid sinus,3 cases mainly located in the nasal septum. Compared to the grey matters,on T1 weighted image, the masses were homogenously isointensity in 7 cases,heterogeneous isointensity in 2 cases, isointensity with patchy hyporintensity in 2 cases. On T2 weighted images,the masses were slightly hyperintensity in 8 cases, hyperintensity with patchy hypointensity in 3 cases, slightly hyperintensity with patchy hyperintensity in 2 cases. In contrast enhanced MRI scanning, MRI displayed clear borders in 7 cases,uneven enhancement in 11 cases, All of the 11 cases showed orbits and antedor cranial fossa meningeal involvement. Conclusions There are some special MRI findings in embryonal rhabdomyosarcoma located in nasal cavity and paranasal sinuses. MRI can depict the encroachment of the tumor accurately, and may play an important role in clinical staging and in curative effect evaluation.