CT与MRI对鼻腔鼻窦神经内分泌癌的诊疗分析

目的分析CT与MRI对鼻腔鼻窦神经内分泌癌（SNEC）的诊疗价值。方法收集2013年4月至2016年10月间的SNEC患者21例，患者均于治疗前接受对应的影像学检查及增强扫描，分析患者的影像学资料。结果21例患者临床症状显著的为鼻塞、涕中带血、流脓涕。专科检测结果多集中在鼻腔通气不畅、腔内可见新生物，而病理类型小细胞型（76．19％）最多。21例患者肿瘤形态特征出现14例肿瘤直径〉3．5cm，呈分叶状；7例〈3．5cm，呈椭圆形；9例双侧，12例单侧，9例累及全组副鼻腔鼻窦；CT示病灶形态不规则，呈分叶状。8例密度均一，10例不均。病灶均侵犯邻近组织，13例出现显著骨质破坏，10例溶骨性破坏，2例膨胀性破坏；增强扫描4例中度强化，2例不均匀。MRI表现患者T1WI示可见条状出血信号；T2WI示可见斑点状变坏死信号；增强扫描6例中度强化，2例不均匀，可见条片状低信号。结论SNEC多见中老年男性，且浸润周边组织与结构。CT示膨胀性钙化性骨质破坏，MRI示出血性信号不均，增强后中度强化，故联合两者可较大提高SNEC的诊断率。

Objective To analyze the value of CT and MtkI in diagnosis and treatment of sinonasal neuroendocrine carcinoma. Methods Twenty-one patients with SNEC were enrolled in our hospital from April 2013 to October 2016. The patients received the corresponding imaging and enhanced scan before treatment. The imaging data of the patients were analyzed. Results 21 patients with clinical symptoms of significant nasal congestion, tears in the blood, purulent nasal discharge. The results of specialist examination focused on nasal ventilation was poor, the cavity could be seen new organisms, while the pathological type of small cell type （ 76.19% ） up. 21 cases of tumor morphological features of 14 cases of tumor diameter〉 3.5 cm was lobulated, 7 cases〈3.5 cm, oval, 9 cases of bilateral, 12 cases of unilateral, 9 cases involving the whole group of nasal cavity and paranasal sinuses. CT showed irregular lesions, was lobuhted. 8 cases of uniform density, 10 cases were uneven. Lesions were associated with adjacent tissue, 13 cases of significant bone injury, 10 cases ofosteolytic injury, 2 cases of dilatation enhanced scan, 4 cases of moderate enhancement, 2 cases of uneven. MRI findings in patients with T1WI shew strip bleeding signal, T2WI showed spotted necrosis signal. Enhanced scan 6 cases of moderate enhancement, 2 cases of uneven, visible strip-hke low signal. Conclusion SNEC is more common in older men, and infiltrate the peripheral tissue and structure. CT shows expansive calcification of bone injury, MRI shows bloody signal uneven, enhances moderate enhancement, so the combination of both can greatly improve the diagnostic rate of SNEC.