60例咽旁隙肿块的CT及MRI影像学特征分析

目的探讨咽旁隙肿块的CT及MRI表现，了解其影像学特征。方法回顾性分析2014年6月~2016年6月收治的60例咽旁隙肿块患者的CT及MRI影像学特征，观察肿块的位置、形态、与周围组织关系、密度、信号高低等情况。结果在60例咽旁隙肿块患者中，神经鞘瘤36例、涎腺混合瘤15例、颈动脉体瘤5例、鼻咽癌颅底咽旁隙转移4例。神经鞘瘤表现为包膜完整、边界光滑、呈椭圆形或圆形的肿块，与腮腺深叶间分界清楚，涎腺混合瘤为包膜完整的圆形肿块，与腮腺深叶间没有脂肪间隙，茎突、二腹肌、腭帆张肌等周围组织均出现移位。颈动脉体瘤表现为形态规则的软组织肿块，CT平扫呈等密度、增强后明显强化；MRI扫描，T1W1呈等或稍高于肌肉信号，T2W1呈不均性的高信号，并可见流空血管影像。鼻咽癌颅底咽旁隙转移的MRI显示，T1W1呈低密度信号的椭圆形肿块，增强后高信号内可见坏死囊变区。结论正确地认识咽旁隙肿块的CT及MRI影像学特征，有助于提高其临床诊断率，为咽旁隙肿块的治疗提供一定的依据。

CT and MRI imaging features of parapharyngeal space masses in 60 patients

Abstract:ObjectiveTo investigate the computerized tomography (CT) and magnetic resonance imaging (MRI) findings of parapharyngeal space tumors, and to understand their imaging features.MethodsThe CT and MRI features of 60 patients with parapharyngeal space masses surgically treated in our hospital from June 2014 to June 2016 were analyzed retrospectively. The imaging features included the location, morphology, tissue density, signal intensity of the masses and their relationship with the surrounding tissues, and so on. ResultsOf all the 60 masses, 36 were schwannoma, 15 were salivary gland mixed tumor, 5 were carotid body tumor, and 4 were metastatic tumor from nasopharyngeal carcinoma. Schwannoma showed up as oval or round mass with complete capsule, smooth border, and clear boundary of tumor body and deep lobe of parotid. Salivary gland mixed tumor manifested as round mass with complete capsule, absence of fat space around deep lobe of the parotid, displacement of styloid process, digastric muscle, tensor veli palatine and other surrounding tissues. Carotid body tumor was represented as regular form of soft tissue mass with equidensity in plain and apparent enhancement in contrast imaging of CT scan, signal intensity similar to or slightly higher than that of muscle on T1WI and unevenly high density signals on T2WI accompanied with signal voids of vessel. The metastatic lesions of nasopharyngeal carcinoma displayed oval-shaped masses with low-density signals on T1W1 and hyperintense on T2WI with areas of cystoid variation and necrosis.ConclusionCT and MRI features of parapharyngeal space tumors can be used to improve the clinical diagnosis rate and provide some basis for the treatment of the parapharyngeal space tumors.