鼻咽癌侵犯鼻窦的MRI表现(附86例病例分析)

目的：分析鼻咽癌侵犯鼻窦的磁共振（MRI）表现,探讨MRI在诊断鼻咽癌侵犯鼻窦中的作用。方法：回顾分析鼻咽癌并鼻窦侵犯的86例患者的MRI表现。结果：MRI表现为窦壁破坏100%,窦壁黏膜增厚52.3%,窦腔内软组织肿块65.1%,鼻窦内侵犯病灶与鼻咽肿瘤相连97.7%,合并积液25.6%。横断面T1WI、T2WI、CE-T1WI所示病灶三者间差异无显著性意义,矢状面T1WI、冠状面FSIR和冠状面CE-T1WI示肿瘤侵犯蝶窦为100%,横断面T2WI和CE-T1WI对显示筛窦、上颌窦受侵最佳。结论：窦壁骨质破坏、连续性中断;窦壁黏膜不均匀性增厚;窦腔内肿块与鼻咽肿瘤主体相连,且有相同程度的强化;T1WI呈等或稍低信号,T2WI为等或稍高信号;增强扫描明显强化,是诊断鼻窦受侵犯的要点。因此,MRI的横断面T2WI、矢状面T1WI、冠状面FSIR及增强扫描在鼻咽癌鼻窦受侵犯的诊断中作用较大。

MRI presentation of involvement of paranasal sinuses with nasopharyngeal carcinoma:analysis of 86 cases

Objective：To study the MR image features for involvement of paranasal sinuses in patients with nasopharyngeal carcinoma （NPC）.Methods：The MRI findings of 86 patients with NPC and paranasal sinuses involvement were evaluated.Results：Among them,86 cases （100%） showed destruction of the walls of paranasal sinuses,45 （52.3%） had thickening of mucous membrane in sinuses,56 （65.1%） showed tumour mass in sinus lumen,84 （97.7%） showed continuity of tumor in sinus and nasopharynx,and 22 （25.6%） showed fluid collection in the sinus.There were no significant differences on Tra T1WI,Tra T2WI and Tra CE-T1WI （P0.05） for demonstration of the lesions in paranasal sinuses.One or more MR imaging protocols could be optimized for displaying involvement of paranasal sinuses.Conclusion：The findings of sinus wall destruction,uneven thickening of the sinus mucous membrane,continuity of tumor in sinus and nasopharynx with same enhancement on MRI may indicate the paranasal sinuses involvement caused by primary tumour.Tra T2WI,Sag T1WI,Cor FSIR and enhanced MRI scanning are helpful to the diagnosis.