鼻窦低度恶性肌纤维母细胞肉瘤的影像表现

Image Features of Low-grade Myofibroblastic Sarcoma of the Paranasal Sinus

目的总结鼻窦低度恶性肌纤维母细胞肉瘤(low grade myofibroblastic sarcoma,LGMS)的影像学表现,以期提高对该病的诊断水平。资料与方法回顾性分析经手术后病理证实的5例LGMS的影像学表现。5例LGMS均行CT平扫,其中1例行CT增强扫描,其余4例行MR平扫+增强扫描。结果 5例LGMS,2例累及右侧上颌窦及筛窦,2例累及双侧筛窦及蝶窦,1例累及左侧各鼻窦。5例均表现为窦腔内不规则形软组织肿块,CT平扫均呈等或稍低密度;MRI检查,T1WI为中等及稍低信号,T2WI为中等及稍高信号,信号不均匀;增强扫描5例均可见中度-明显强化。5例肿瘤周围均出现虫蚀样溶骨性骨质破坏。结论鼻窦LGMS的影像学表现为鼻窦内软组织肿块伴溶骨性骨质破坏,增强扫描中度-明显强化,影像学检查有助于确定肿瘤的的侵犯范围。

Objective To evaluate the image features of low-grade myofibroblastic sarcoma（LGMS） of paranasal sinus, and improve the diagnostic accuracy. Matei/a/~ and Method,~ A retrospective analysis of 5 cases of paranasal sinus LGMS was carried out. Of the 5 patients, all of them underwent common CT, 1 patient underwent contrast- enhanced CT and 4 underwent common MRI and contrast-enhanced MR1. Results Of the 5 patients, 2 occurred in the right maxillary, sinus and ethmoidal sinus, 2 occurred in the sphenoid sinus and ethmoidal sinus, 1 occurred in all of the left paranasal sinus. CT scan showed hypo-indense and iso-indense soft tissue mass in the paranasal sinus. TIWI showed isointense mass and T2W1 showed isointense and hyperintense mass. Contrast images showed moderate-obvious homogeneous enhancement. All of the 5 cases showed bone destruction. Conclusion LGMS of the paranasal sinus can be characterized as a soft tissue mass with bone destruction, hut it is difficult to differentiate from other malignant diseases, hnage features can help to determine the extent of the lesion.