嗅神经母细胞瘤MRI表现

目的：探讨嗅神经母细胞瘤的MRI影像学表现及临床特点,提高对该疾病的认识。方法：搜集经手术病理证实的嗅神经母细胞瘤10例完整资料,所有病例均行MR平扫与增强扫描,其中3例行CT平扫。回顾性分析其临床及影像学表现。结果：10例嗅神经母细胞瘤中除异位于左侧蝶骨-鼻咽部和鞍区各1例未分期,A期0例,B期1例,C期7例。B期1例侵犯筛窦,C期7例均破坏筛骨,其中1例累及仅眼眶,6例突破前颅底硬脑膜而累及脑实质,部分肿瘤破坏蝶骨、上颌骨或眼眶。MR平扫肿瘤实性部分T1WI呈等或稍低信号,T2WI呈等或稍高信号,增强后实性部分呈现中度至明显强化,肿块信号多不均匀,内出现囊变、出血或坏死。C期累及脑实质时5例病灶周围出现不同程度水肿,1例无明显水肿。结论：MR可准确显示嗅神经母细胞瘤的部位、形态、信号改变及累及范围,对于其定位、定性、分期、治疗方案的制定及预后具有重要价值。

Manifestations of Esthesioneuroblastoma on MRI

Objective：To investigate the MRI findings and clinical characteristic of esthesioneuroblastoma. Methods： Esthesioneuroblastoma in 10 cases was verified with histopathology. Pre- and post-contrast MRI were performed in all patients and CT scans were done in 3 cases, the clinical data and MRI findings were reviewed retrospectively. Results： In all the 13 cases,except a primary sellar esthesioneuroblastoma and a sphenoid-pharynx nasalis esthesioneuroblastoma, 1 case was classified as grade Ⅱ ,and 7 cases were grade Ⅲ. The grade Ⅱ case and all grade Ⅲ cases invaded the ethmoid sinuse,6 cases broke through the dura of skull base and the brain parenchyma was involved,some cases destructed sphenoid,maxillary bone or fossa orbitalis. On MRI, the solid part of masses demonstrated heterogeneous signal intensity, which manifested as slightly hypointensity on T1 WI and slightly hyperintensity on T2 WI, with moderate to obvious enhancement after contrast scan. The signal intensity of the lesions was often heterogeneous, cystic component, hemorrhage or necrosis were found. 5 cases of brain tissue surrounding the tumors showed an appearance of edema. Conclusion： As MRI can clearly depict the location, shape, signal change and extension of esthesioneuroblastoma, it is of vital value in its diagnosis, staging, therapeutic regimen and prognosis.