鼻咽部血管纤维瘤的影像学诊断价值

Diagnostic value of imaging for nasopharyngeal angiofibroma

目的:探讨鼻咽部血管纤维瘤影像学的价值。方法:回顾分析经手术病理证实的血管纤维瘤的CT、MRI、DSA特征,CT检查13例,MRI4例和DSA3例,同时完成2项或3项检查分别为4例和3例。结果:13例均显示出病变的部位及范围,CT平扫示软组织块为等密度或稍高密度。MRI示肿块T1WI呈等于或略高于肌肉信号,T2WI呈高信号。肿块增强扫描明显强化,CT强化密度曲线呈速升缓降型;MRI信号增强率升高。3例DSA显示供血情况以及营养血管的特征。结论:血管纤维瘤有特征性的CT和MRI表现,CT动态扫描、MRI增强率的表达及DSA有助于诊断和鉴别诊断。

Objective:To study the value of diagnostic imaging in nasopharyngeal angiofibroma. Methods:The imaging findings of 13 cases of angiofibroma proved pathologically were retrospectively analyzed,all were examined by CT,4 by MRI and 3 by DSA. Combination of two or three kinds of examinations was performed in 4 and 3 cases,respectively. Results;The location and extent of lesions were defined in all 13 cases. The tumor presented as irregular mass with isodensity or slight hyper-density in CT plain scan,while the lesion showed equal or slightly higher signal intensity than muscle on TlWI,and hyperintensity signal on T2WI. The mass was markedly enhanced after administration of contrast material, of which the time-density-curve appeared as fast increase and slow decrease pattern in enhanced CT scans, and the signal enhancement rate increased on MRI. The amount of vascularity and the nature of the feeding vessels were defined on DSA in all 3 cases. Conclusion: Angiofibroma has specific appearance in CT,DSA and MRI. CT dynamic enhancement scan,enhancement rate of MRI and DSA may all play a role in the diagnosis and differential diagnosis of angiofibroma.