Imhof H, Henk C B, Dirisamer A, Czerny C, Gstöttner W
Abteilung für Osteologie/Universitätsklinik Radiodiagnostik, AKH Wien, Vienna, Austria.
Radiologe. 2003 Mar;43(3):219-26. doi: 10.1007/s00117-003-0870-2.
Tumours lesions of the temporal bone and of the cerebello-pontine angle are rare. This tumours can be separated into benign and malignant lesions. In this paper the CT and MRI characteristics of tumours of the temporal bone and the cerebello-pontane angle will be demonstrated. High resolution CT (HRCT) as usually performed in the axial plane are using a high resolution bone window level setting, coronal planes are the reconstructed from the axial data set or will be obtained directly. With the MRI FLAIR sequence in the axial plane the whole brain will be scanned either to depict or exclude a tumour invasion into the brain. After this,T2-weighted fast spin echo sequences or fat suppressed inversion recovery sequences in high resolution technique in the axial plane will be obtained from the temporal bone and axial T1-weighted spin echo sequences before and after the intravenous application of contrast material will be obtained of this region. Finally T1-weighted spin echo sequences in high resolution technique with fat suppression after the intravenous application of contrast material will be performed in the coronal plane. HRCT and MRI are both used to depict the most exact tumorous borders. HRCT excellently depicts the osseous changes for example exostosis of the external auditory canal, while also with HRCT osseous changes maybe characterized into more benign or malignant types. MRI has a very high soft tissue contrast and may therefore either characterize vascular space-occupying lesions for example glomus jugulare tumours or may differentiate between more benign or malignant lesions. In conclusion HRCT and MRI of the temporal bone are excellent methods to depict and mostly characterize tumour lesions and can help to differentiate between benign and malignant lesion. These imaging methods shall be used complementary and may have a great impact for the therapeutic planning.
颞骨及小脑脑桥角的肿瘤病变较为罕见。这类肿瘤可分为良性和恶性病变。本文将展示颞骨及小脑脑桥角肿瘤的CT和MRI特征。通常在轴位平面进行的高分辨率CT(HRCT)采用高分辨率骨窗设置,冠状面则从轴位数据集重建或直接获取。使用轴位平面的MRI FLAIR序列对全脑进行扫描,以描绘或排除肿瘤向脑内的侵犯。在此之后,将在轴位平面以高分辨率技术获取颞骨的T2加权快速自旋回波序列或脂肪抑制反转恢复序列,并在静脉注射对比剂前后获取该区域的轴位T1加权自旋回波序列。最后,在冠状面进行静脉注射对比剂后采用高分辨率技术且带有脂肪抑制的T1加权自旋回波序列。HRCT和MRI均用于描绘最精确的肿瘤边界。HRCT能出色地显示骨质改变,例如外耳道骨疣,同时通过HRCT也可将骨质改变分为更良性或恶性类型。MRI具有非常高的软组织对比度,因此既可以对血管性占位性病变(例如颈静脉球瘤)进行特征性描述,也可以区分更良性或恶性的病变。总之,颞骨的HRCT和MRI是描绘和大多特征化肿瘤病变的优秀方法,有助于区分良性和恶性病变。这些成像方法应互补使用,对治疗规划可能有很大影响。