头颈部腺样囊性癌的MRI诊断

目的 加强对头颈部腺样囊性癌的认识,提高术前MRI诊断准确率.材料与方法回顾性分析20例经病理证实的头颈部腺样囊性癌MR影像资料,其中15例同时行CT检查.结果 20例中病变主体位于鼻腔副鼻窦7例,眼眶5例,翼腭窝3例,颅、鼻、眶广泛受累2例,舌根2例,外耳1例.病变累及邻近2个以上解剖结构者15例,其中累及翼腭窝9例,上颌神经受累9例,下颌神经受累6例,翼管神经受累8例,中颅窝及海绵窦受累8例.在T1WI肿瘤实质以等信号为主13例,稍低信号为主7例;T2WI以等信号为主13例,稍高、高信号7例,20例信号都不均匀.增强扫描病变实质部分明显花斑状强化8例,中等程度强化12例,11例动态增强扫描

MRI diagnosis of adenoid cystic carcinoma of the head and neck

Objective：To study the MRI findings of adenoid cystic carcinoma（ACC） of the head and neck.Materials and Methods：All 20 cases of ACC were verified by histopathology.MRI data were analyzed retrospectively.Meantime,CT scanning were done in 15 cases.Results：The lesion mainly occurred in nasal cavity and paranasal sinus in 7 cases,in orbital 5 cases,in pterygopalatine fossa 3 cases,cranium,nasal and orbital were diffuse involved 2 cases,in root of tongue 2 cases,in external ear 1 case.The lesion involved two and more anatomic structures 15 cases,among them 9 cases involved pterygopalatine fossa,9 cases involved maxillary nerve,6 cases involved mandibular nerve,8 cases involved nerve of pterygoid canal,8 cases involved middle cranial fossa and cavernous sinus.On MR T1WI,the lesion showed isointensity in 13 cases and slightly hypointensity in 7 cases.On T2WI,the lesion showed isointensity in 13 cases,slightly or hyperintensity in 7 cases.All 20 cases showed heterogeneous intensity,showed short T1 and long or mixed T2 signal in 4 cases.Postcontrast MRI demonstrated obvious heterogeneous enhancement in 8 cases,moderate enhancement in 12 cases.Among 11 cases dynamic contrast MRI,dynamic contrast curve showed rapid ascend,then platform 7 cases,persistent ascend 4 cases.On CT of 15 cases,showed osteolytic bony destruction in 13 cases.Conclusion：MRI can demonstrate the invaded extent of the lesions clearly,and can provide more comprehensive information in diagnosis and therapy of adenoid cystic carcinoma of the head and neck.