青年男性鼻咽顶后壁MRI观察下腺样体的特征

 目的 探讨MRI观察下青年男性腺样体的特征。方法 回顾性分析2021-06至2022-05在武警浙江总队医院体检的1547名青年男性的头颅MRI图像,观察鼻咽顶后壁是否有腺样体及其MR信号特点、大体形态,测量腺样体最大厚度。结果 93.92%的青年男性鼻咽顶后壁可观察到残留的腺样体,平均最大厚度(7.66±2.80)mm,中位最大厚度7.32(5.58,9.25)mm,残留的腺样体最大厚度多为5～＜10 mm,占比66.62%。MRI图像上腺样体表现为鼻咽顶后壁软组织块影,呈长T₂信号,黏膜连续、完整,信号均匀,左右对称;邻近咽隐窝可因肿块受压变窄,咽旁间隙及周围骨质无异常改变,部分腺样体内可见囊肿。根据MRI正中矢状位的形态主要分为4种,镰刀形(241名)、新月形(601名)、D字形(501名)、纺锤形(110名),其中以新月形与D字形最为常见,纺锤形最大厚度最大,平均最大厚度为(12.53±3.03)mm。结论 多数青年男性鼻咽顶后壁可发现残留的腺样体,根据其对称性肿块、无邻近组织侵犯等特点,鉴别诊断不难。MRI正中矢状位能准确观察腺样体形态并精准测量其厚度,为临床提供了全面直观的影像学信息。

MRI-based features of adenoids in young men

Objective To investigate the characteristics of adenoids in young males based on MRI observation.Methods The brain magnetic resonance images of 1547 young men who got health check-up in Zhejiang Provincial Corps Hospital of Chinese People's Armed Police Force from June 2021 to May 2022 were retrospectively analyzed to observe whether there were adenoids in the posterior wall of the nasopharynx, their MR signal characteristics, and general morphology, and the maximum thickness of the adenoids was measured.Results Residual adenoids could be observed in 93.92% of the young men, with an average maximum thickness of (7.66±2.80)mm and a median maximum thickness of 7.32 (5.58, 9.25) mm. The maximum thickness of the adenoids spanned from 5.00 mm to less than 10 mm, accounting for 66.62%. On MRI images, the adenoids appeared as soft tissue masses in the posterior wall of the nasopharyngeal roof, showing long T₂ signal, the mucosa was continuous and complete, the signal was uniform, and the signal was symmetrical. No abnormal changes in bone or cysts could be seen in the adenoids. According to the MRI mid-sagittal shapes of residual adenoids, there were mainly four types: sickle shape (241 cases), crescent shape (601 cases), D shape (501 cases), spindle shape (110 cases), among which crescent-shape and D-shape were the most common, and the spindle shape was the largest, with an average maximum thickness of (12.53±3.03)mm.Conclusions Residual adenoids can be found in the posterior wall of the nasopharynx in most young men. The differential diagnosis is not difficult with the characteristics of symmetrical masses and no invasion of adjacent tissues. The mid-sagittal MRI can accurately observe the adenoid morphology and accurately measure its thickness, providing comprehensive and intuitive imaging information for clinical use.