颞下窝占位病变的CT和MRI特点分析

CT and MRI Feature Analysis of 51 Infratemporal Fossa Occupying Lesions

目的分析累及颞下窝占位病变的影像特点,提高诊断认识。方法回顾性分析51例颞下窝占位病变患者的CT及MRI影像表现及临床资料。结果原发颞下窝占位21例,良性12例,包括神经鞘瘤3例,血管畸形2例,骨巨细胞瘤2例,脂肪瘤、皮样囊肿、动脉瘤样骨囊肿、脓肿、海绵状血管瘤各1例;恶性9例,包括软骨肉瘤3例,淋巴瘤、恶性神经鞘瘤、脊索瘤、平滑肌肉瘤、肌纤维母细胞瘤及肺癌转移瘤各1例。继发累及颞下窝占位30例,良性21例,包括神经鞘瘤13例,脑膜瘤5例,巨细胞修复性肉芽肿、鼻咽纤维血管瘤、慢性肉芽肿各1例;恶性9例,包括鼻咽癌4例,腺样囊性癌3例,上颌窦癌、腮腺浸润性导管癌各1例。良性占位多边缘光滑,与周围分界清,膨胀性骨质改变;恶性占位密度、信号混杂,边界不规则,浸润性生长,溶骨性骨质破坏。CT多能显示邻近骨质受累情况,MRI对病变的诊断及鉴别诊断有较大帮助。结论颞下窝占位病变种类多样,CT及MRI能清晰显示病变特点,有利于病变定性及临床决策制定。

Objective To analyze the imaging features of the lesions involving the infratemporal fossa and to improve the diagnostic understanding.Methods The CT and MRI findings and clinical data of 51 cases of infratemporal fossa occupying lesions were retrospectively analyzed.Results There were 21 cases of primary infratemporal fossa occupying lesions;12 benign cases,including 3 cases of schwannomas,2 cases of vascular malformations,2 cases of giant cell tumor of bone,1 case of lipoma,dermoid cyst,aneurysmal bone cyst,abscess,spongiform hemangioma;9 malignant cases,including 3 cases of chondrosarcoma,1 case of lymphoma,malignant schwannoma,chordoma,leiomyosarcoma,myofibroblastic tumor and metastatic tumor of lung cancer.There were 30 cases of lesions which were secondary involvement in the infratemporal fossa;21 benign cases,including 13 cases of schwannomas,meningioma 5 cases,1 case of giant cell reparative granuloma,nasopharyngeal angiofibroma and chronic granuloma;9 malignant cases,including 4 cases of nasopharyngeal carcinoma,3 cases of adenoid cystic carcinoma,1 case of maxillary sinus cancer and invasive ductal carcinoma of the parotid gland.Benign masses had well-defined border,clear boundary with surroundings,bone remodeling.Malignant masses had heterogeneous density or signal,irregular boundary,invasive growth,and osteolytic bone destruction.CT could display the bone involvement and MRI was helpful for the diagnosis and differential diagnosis of the lesions.Conclusion There were various types of lesions in the infratemporal fossa.CT and MRI can clearly show the characteristics of the lesion,which were conducive to for qualitative diagnosis and clinical decision making.