上颌窦区肿瘤的影像鉴别诊断

目的结合上颌窦区3种肿瘤的影像特征,提高上颌窦区肿瘤的鉴别诊断能力。方法通过观察对比上颌窦区腺样囊性癌、神经纤维瘤和骨化性纤维瘤(各1例)的临床特点及CT、MRI表现,分析上颌窦区肿瘤的影像表现异同点。结果上颌窦腺样囊性癌表现为边界不清,受累窦壁骨质呈溶骨性骨质破坏,MRI呈混杂T_1、T_2信号,不均匀强化。翼腭窝神经纤维瘤表现为边界清,邻近骨质呈压迫性骨质吸收,MRI呈混杂等长T_2信号,增强扫描呈不均匀强化。骨化性纤维瘤表现为边界清,窦壁骨质呈膨胀性改变,有骨性包壳,MRI呈混杂T_1、T_2信号,不均匀强化。结论骨质改变是上颌窦区肿瘤鉴别诊断的关键点,最终诊断需要结合临床、CT和MRI表现。

Imaging differential diagnosis of tumors involved maxillary sinus area

Objective To improve the ability in diagnosing the tumors involved the maxillary sinus region through exploring the imaging characteristics of three kinds of diseases. Methods The clinical features, CT, and MRI appearances of neurofibroma, adenoid cystic carcinoma, and ossifying fibroma involved the maxillary sinus were observed. The imaging similarities and differences were analyzed. Results Maxillary sinus adenoid cystic carcinoma showed unclear boundary and osteolytic bone destruction. MRI demonstrated heterogeneous signal on T1WI and T2WI, and heterogeneous enhancement. Neurofibroma at pterygopalatine fossa revealed clear boundary and compressive bony absorption in adjacent bone. MRI showed heterogeneous signal on T2WI, and heterogeneous enhancement. Ossifying fibroma showed clear boundary and expansile bony change with osseous shell. MRI revealed heterogeneous signal on T1WI and T2WI, and heterogeneous enhancement. Conclusions The bony change is the key point for differential diagnosing the tumors involved the maxillary sinus. The finial diagnosis relies on combining the clinical, CT, and MRI findings.