恶性肉芽肿的CT、MRI诊断及病理探讨

目的：探讨恶性肉芽肿的CT、MRI诊断及病理表现。方法：9例患者，男7例，女2例，均行CT、MRI检查，病理证实为恶性肉芽肿。结果：发生于鼻面部8例，表现为鼻腔、鼻中隔、鼻甲、上颌窦、筛窦、蝶窦黏膜增厚，左右大致对称，不同有质破坏，7例有软组织肿块，5例邻近脑组织受累。中耳病变1例表现为软组织肿块和骨质破坏。所有病灶在T2WI信号强度并非很高，表现为等或略高信号。增强扫描病变呈明显强化。病理显示有较多的淋巴细胞、浆细胞浸润，4例经免疫组化染色进一步证实了T淋巴细胞性淋巴瘤。结论：CT、MRI均能很好地显示病变部位和范围，观察软组织情况以及MRI为佳，T2WI病灶呈略高信号，骨质破坏情况CT更可靠，二者更有利于本病的诊断。

CT, MRI and Pathology Study of Malignant Granuloma

Objective To evaluate CT and MRI in diagnosis of granuloma. Methods 9 cases (male 7 cases, female 2 cases)were scanned with CT and MRI. Pathologic diagnosis was malignant granuloma. Results 8 occurred in midline facial structure. The mucosas of nasal cavity, nasal septum, concha, and nasal sinuses were showed thickened symmetrically, destruction of bones, 7 showed soft tissue masses, 5 showed their brains were involved. Only 1 occurred in middle ear, showed destruction of bone and soft tissue mass. All were enhanced after injecting contrast through veins. Pathology showed more lymphocytes and plasmocytes, 5 were made sure of T cell lymphoma. Conclusion Both CT and MRI can show satisfactorily the locations and ranges of lesions.