Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt.
Eur Arch Otorhinolaryngol. 2013 Mar;270(3):985-8. doi: 10.1007/s00405-012-2247-5. Epub 2012 Nov 4.
To evaluate the role of MR imaging in patients with laryngoscleroma. We retrospectively reviewed the MR imaging of 14 patients (11 female, 3 male with mean age of 31 years) with pathologically proven laryngoscleroma. They presented with dysphonia (n = 12), stridor (n = 8) and airway obstruction (n = 4). They underwent T1- and T2-weighted MR images and post contrast study after injection of 0.1 mmol Gd/DTPA. Laryngoscleroma was seen in the subglottic (n = 13) and supraglottic (n = 1) regions. Laryngoscleroma at granulomatous stage (n = 6) appeared as diffuse circumferential soft tissue mass with high (n = 4) or mixed (n = 2) signal intensity on T2-weighted images with homogenous (n = 4) and inhomogeneous (n = 2) pattern of contrast enhancement. At fibrotic stage (n = 8), laryngoscleroma was seen as diffuse asymmetrical circumferential thickening of the subglottic region with low signal intensity on T2-weighted images and mild contrast enhancement. Subglottic lesions encircled the subglottic region with marked (n = 5) and mild (n = 9) narrowing of the airway with variable degree of extension into the trachea in three patients. There was diffuse thickening of the epiglottis, aryepiglottic folds in one patient with supraglottic scleroma. MR imaging is a non-invasive imaging modality for accurate localization, extension and staging of laryngoscleroma. These data is important for treatment planning.
评估磁共振成像在喉硬结病患者中的作用。我们回顾性分析了 14 例经病理证实的喉硬结病患者(11 例女性,3 例男性;平均年龄 31 岁)的磁共振成像资料。患者表现为发音困难(n = 12)、喘鸣(n = 8)和气道阻塞(n = 4)。所有患者均行 T1 加权和 T2 加权磁共振成像及 0.1mmol Gd-DTPA 注射后对比增强检查。喉硬结病发生于声门下区(n = 13)和喉上部(n = 1)。肉芽肿期喉硬结病(n = 6)表现为弥漫性环状软组织肿块,T2 加权像上呈高信号(n = 4)或混杂信号(n = 2),增强后呈均匀(n = 4)或不均匀(n = 2)强化模式。纤维化期喉硬结病(n = 8)表现为声门下区弥漫性不对称环状增厚,T2 加权像上呈低信号,轻度强化。声门下区病变环绕声门下区,3 例患者气道狭窄明显(n = 5)或轻度(n = 9),程度不一,向气管延伸。1 例合并喉上部硬结病患者可见会厌、杓会厌皱襞弥漫性增厚。磁共振成像是一种非侵入性成像方式,可准确定位、评估喉硬结病的范围和分期。这些资料对治疗计划很重要。