MRI和CT诊断嗅神经母细胞瘤的影像表现探讨

The exploration into the imaging manifestations of esthesioneuroblastoma on CT and MRI

目的：探讨嗅神经母细胞瘤（esthesioneuroblastoma ，ENB）的 CT 及 MRI 影像学表现及临床特点。方法收集经病理证实的 ENB22例，分别行 CT （10／22）、MRI（12／22）扫描，分析整理并记录病灶位置、形态、强化表现、侵犯范围及 Kadish 分期等。结果22例患者平均年龄52岁（9-76岁），男14例，女8例，病变分别位于左侧鼻腔11例（11／22），右侧鼻腔9例（9／22），前颅底2例（2／22），形态规则7例（7／22），不规则15例（15／22），CT 平扫为软组织密度肿块影10例（10／22），CT 值45-58HU ，增强后3例（3／10）病灶明显强化，CT 值105-114HU 。 MRI 显示等信号软组织3例（3／12）；T1 WI 不均匀低信号9例（9／12），T2 WI 均为高信号，信号明显不均匀2例（2／12），信号均匀10例（10／12）；增强扫描呈不均匀的中等或明显强化12例（12／22）。肿瘤累及上颌骨、筛骨、鼻中隔或颅底骨质破坏16例（16／22），伴颈部淋巴结转移7例（7／22）。 A 期6例，B 期4例，C 期12例。结论 CT 及 MRI 能很好显示 ENB 影像特点及侵犯方式，并进行分期诊断。

Objective To investigate the CT and MRI manifestations and clinical characteristics of esthesioneuroblasto‐ma .Methods CT （10/22） and MRI（12/22） findings of 22 cases with olfactory neuroblastoma proved by pathology were analyzed retrospectively ,and particular attention was paid to tumor location ,form ,extension ,enhancement pattern and Kadish stage .Results The cases included 14 males and 8 females ,and the mean age was 52 years（ ranged from 9 to 76 years） .The locations of the tumors included the left side of the nasal cavity 11 cases （11/22） ,the right side of the nasal cavity was found in 9 cases （9/22） and anterior skull in 2 cases （2/22） .7 cases （7/22） were regular in shape ,while the 15 cases （15/22） were irregular .10 cases （10/22） had plain CT scan that showed mass with soft tissue density .CT value was 45 - 58 HU .3 of them were obviously enhancement after contrast‐enhanced CT scan .CT value was 105 - 114 HU . 12 cases underwent routine plain scan and enhanced scan .MRI showed equal signal of soft tissue in 3 patients （3/12） .9 cases exhibited T1 uneven slow signal .The mass in 12 cases all showed T2 high signal .The signals of 2 cases （2/12） were heterogeneous .The signal of 10 cases （10/12） were uniform .Contrast enhancement was either moderate or obvious ,and all of variable uniformity .The tumors involving maxillary and ethmoid bone ,the septum ,or skull base bony destruction could be seen in 16 cases （16/22） ,with 7 cases （7/22） manifesting cervical lymph node metastasis .There were 6 cases of phase A ,4 cases of the phase B ,and 12 cases of phase C .Conclusion CT and MRI can show ENB image characteristics and infringement ,and staging diagnosis .