Han M H, Chang K H, Lee C H, Seo J W, Han M C, Kim C W
Department of Diagnostic Radiology, Seoul National University College of Medicine, Korea.
AJNR Am J Neuroradiol. 1991 Jan-Feb;12(1):25-30.
Five cases of pathologically proved psammomatoid ossifying fibromas of the sinonasal area are presented. All five cases were examined by CT and in three cases MR imaging was performed before and after injection of gadopentetate dimeglumine. The lesions were located in the sphenoethmoidal area and extended over the nasal cavity or orbit in four cases. In one case, the lesion occurred at the perpendicular plate of the ethmoid bone with preservation of the ethmoidal sinus. On CT, all the lesions were expansile and circumscribed by a thick bony wall. Internal septations of bone density (four cases) or enhancing soft-tissue density (one case) were seen and internal content was low in density in all but one from which blood was aspirated. On MR, the bony walls were isointense with gray matter on T1-weighted images and were seen as areas of low intensity on T2-weighted images. The lesions significantly enhanced after injection of contrast material. A well-circumscribed multiloculated expansile mass with a thick wall of bone density on CT scans and enhancement of this area on postcontrast MR images is strongly suggestive of psammomatoid ossifying fibroma.
本文报告5例经病理证实的鼻窦区沙砾样骨化纤维瘤。所有5例均行CT检查，其中3例在注射钆喷酸葡胺前后进行了磁共振成像（MR）检查。病变位于蝶筛区域，4例累及鼻腔或眼眶。1例病变发生于筛骨垂直板，筛窦未受侵犯。CT表现为所有病变均呈膨胀性生长，有厚骨壁包绕。可见骨密度的内部间隔（4例）或强化的软组织密度影（1例），除1例吸出血液外，其余病变内部密度均较低。MR上，骨壁在T1加权像上与灰质信号等，在T2加权像上呈低信号区。注射对比剂后病变明显强化。CT扫描显示边界清晰的多房膨胀性肿块，有厚的骨密度壁，增强后MR图像上该区域强化，强烈提示为沙砾样骨化纤维瘤。
