鼻腔及鼻窦粘膜恶性黑色素瘤的CT评价

CT Evaluation of the Primary Nasal and Paranasal Malignant Melanoma

目的 探讨鼻腔及鼻窦恶性黑色素瘤的CT诊断价值。材料与方法 回顾性分析 8例经病理证实的鼻腔及鼻窦恶性黑色素瘤的CT征象。结果 8例肿瘤均无钙化 ,注射碘对比剂后病灶有不同程度强化。CT冠状位及轴位扫描显示肿块位于单侧鼻、窦腔 6例 ,双侧 2例 ;病灶中心位于鼻腔前下 4例 ,鼻腔上部及筛窦 4例 ;肿瘤侵犯邻近结构 ,包括上颌窦 4例 ,突破筛骨纸板到眶骨膜下间隙 7例 ,向上破坏筛骨水平板和蝶平面 ,并浸润相应脑膜 2例。结论 CT能很好地显示窦鼻腔恶性黑色素瘤的病变部位、周围骨质破坏和邻近重要结构的侵犯。尽管这些表现缺乏特征 ,对该肿瘤的定性诊断帮助不大 。

Objective To evaluate CT scanning in the diagnosis of nasal and paranasal melanoma.Materials and Methods CT features in 8 patients with pathologically proved nasal or paranasal malignant melanoma were retrospectively analyzed. CT findings on axial and coronal planes were compared with histopathologic results by two senior radiologists.Results No calcification was seen within the tumors in all 8 cases. The lesions showed enhancement up to different degrees following the injection of contrast media. On axial and coronal CT scans, the lesions were unilateral (n=6) or bilateral (n=2), the tumor's center were located in the anterior inferior part of the nasal cavity (n=4) or in the upper part of the nasal cavity and ethmoid (n=4). The adjacent structures were involved, including maxillary sinus (n=4), orbit (n=7), anterior cranial fossa (n=2) and bony destruction (n=8). Destruction of lamina papyracea was characteristic. Conclusion CT can provide an overall evaluation of nasal and paranasal malignant melanoma although few CT signs are characteristic.