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常见单侧良性鼻腔鼻窦病变的影像学特点及鉴别诊断

Imaging characteristics and differential diagnosis of common unilateral benign nasal and sinus diseases
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摘要 目的回顾常见单侧良性鼻腔鼻窦病变的CT和增强MRI的影像学特征,总结与恶性病变的鉴别要点。方法共134例单侧良性鼻腔鼻窦病变纳入本研究,术前进行鼻窦CT及增强MRI检查。记录总结各病种的CT及MRI影像学特征、病变范围、病变周围骨质和结构的侵犯和破坏情况。结果单侧病变CT表现为大致均匀的软组织密度影。受累鼻窦骨质表现为内部钙化、窦壁局部骨质增生、窦壁广泛均匀的向心性骨质增生肥厚、窦壁骨质膨胀性破坏、窦壁骨质虫蚀状破坏的,分别有33、13、29、9、5例。MRI T1WI表现为大致均匀的等信号影。增强T1像呈现轻度、中度和明显强化的病例分别有3、10、108例,表现为混杂信号的有55例。结论单侧良性病变影像学表现各异。CT可对单侧病变内钙化等高密度阴影及周围骨质变化呈现较为清晰的影像。鼻窦增强MRI则能够对病变内部的不同成分提供更丰富的信息。应结合鼻窦CT及增强MRI影像学特点对单侧病变进行仔细鉴别。 OBJECTIVE To retrospectively summarize the CT and enhanced MRI imaging characteristics of common unilateral benign nasal and sinus lesions and to outline key po ints for differentiation from malignant lesions.METHODS A total of 134 cases of unilateral benign nasal and sinus lesions were included in this study,with preoperative sinus CT and enhanced MRI examinations performed.The imaging characteristics of CT and MRI,the extent of the lesions,and the involvement and destruction of surrounding bone and structures were recorded and summarized for each type of lesion.RESULTS Unilateral lesions on CT appeared as generally homogeneous soft tissue density shadows.The affected sinus bones showed internal calcification,localized bone hyperplasia of the sinus wall,extensive uniform centripetal bone hyperplasia and thickening of the sinus wall,expansive destruction of the sinus wall bone,and worm-eaten destruction of the sinus wall bone in 33,13,29,9,and 5 cases,respectively.On MRI T1WI,the lesions appeared as generally homogeneous isointense shadows.Enhanced T1 images showed mild,moderate,and significant enhancement in 3,10,and 108 cases,respectively,with 55 cases presenting as mixed signals.CONCLUSION The imaging manifestations of unilateral benign lesions vary.CT can clearly present high-density shadows such as calcifications within unilateral lesions and changes in surrounding bone.Enhanced MRI of the sinuses provides richer information about the different components within the lesions.Careful differentiation of unilateral lesions should be performed by combining the imaging characteristics of sinus CT and enhanced MRI.
作者 董怿 崔顺九 黄谦 王向东 王新艳 DONG Yi;CUI Shunjiu;HUANG Qian;WANG Xiangdong;WANG Xinyan(Department of Otolaryngology Head and Neck Surgery,Key Laboratory of Otolaryngology Head and Neck Surgery(Capital Medical University),Ministry of Education,Beijing,100730,China;Department of Radiology,Beijing Tongren Hospital,Capital Medical University,Beijing,100730,China)
出处 《中国耳鼻咽喉头颈外科》 CSCD 2024年第5期311-316,共6页 Chinese Archives of Otolaryngology-Head and Neck Surgery
基金 首都医科大学附属北京同仁医院院基金(2023-YJJ-PY-003)。
关键词 鼻腔 磁共振成像 体层摄影术 X线计算机 诊断 鉴别 单侧病变 鼻窦 影像学 Nasal Cavity Magnetic Resonance Imaging Tomography,X-Ray Computed Diagnosis,Differential unilateral lesions sinuse imaging
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