鼻咽部纤维血管瘤的CT初步诊断

目的：探讨多层螺旋CT对鼻咽部纤维血管瘤（nasopharyngeal fibroangioma）临床分期的诊断价值。方法回顾性分析我院40例经手术及病理证实的鼻咽部纤维血管瘤的临床及CT资料，分析瘤体组织的大小、形态、边界、密度、强化方式及邻近组织结构的变化情况。结果按Radkowski分期，40例鼻咽部纤维血管瘤患者可分为7期院其中，玉a期3例，玉b期9例，Ⅱa期8例，Ⅱb期10例，Ⅱc期5例，芋a期3例，芋b期2例。40例鼻咽部纤维血管瘤患者，侵犯最多的部位为鼻咽、翼腭窝、蝶窦、上颌窦及眼眶，其次为颞下窝，少数侵犯颊部、海绵窦及颅底骨质。 CT平扫瘤体以等或稍低密度为主，增强扫描呈明显强化。结论 CT对鼻咽部纤维血管瘤的临床分期诊断、术前定位及术后预后评估具有重要的临床价值。

CT initial diagnosis value of nasopharyngeal fibroangioma

Objective To explore the diagnostic value of multi-slice spiral CT in clinical stage of nasopharyngeal fi-broangioma. Methods The clinical data and imaging findings of CT in 40 patients with nasopharyngeal fibroangioma confirmed by operation and pathologic examination were retrospectively analyzed. The size, shape, density, boundary, strengthen and the changes of the adjacent structure of the mass were observed and analyzed. Results According to Radkowski classification, 3 cases were evaluated as stageⅠa, 9 cases were evaluated as stage Ⅰb, 8 cases were eval-uated as stage IIa, 10 cases were evaluated as stage IIb, 5 cases were evaluated as stage IIc, 3 cases were evaluated as stageⅢa and 2 cases were evaluated as stageⅢb. Most corrosive location were in nasopharynx, pterygopalatine fos-sa, sphenoid sinus, maxillary sinus, eye socket and followed occurred in fratemporal fossa, and few corrosive location were in sclerotin of pars buccalis, cavernous sinus and basis cranii. The tumor showed uniform and slightly lower den-sity but obviously strengthening after administration of Gd-DTPA. Conclusion Multi-slice spiral CT has important clinical value for the clinical stage diagnosis, preoperative localization, evaluating the postoperative extent and the prognosis of the nasopharyngeal fibroangioma.