Lesser F D, Derbyshire S G, Lewis-Jones H
Emergency Department,Queen's Hospital,Romford,UK.
Department of ENT,Aintree University Hospital,Liverpool,UK.
J Laryngol Otol. 2015 Sep;129(9):852-9. doi: 10.1017/S0022215115001991.
Central skull base osteomyelitis is clinically difficult to distinguish from malignancy.
The computed tomography and magnetic resonance imaging scans of six patients with central skull base osteomyelitis were compared with scans from patients with a range of skull base conditions.
Computed tomography scans of central skull base osteomyelitis show much less bony destruction relative to the magnetic resonance imaging changes, whereas malignancy cases were associated with similar bony destruction on computed tomography and magnetic resonance imaging. In magnetic resonance imaging scans, it was possible to confirm previous findings of clival hypointensity on T1-weighted images relative to normal fatty marrow. In addition, there were signs of pre- and para-clival soft tissue infiltration, with the obliteration of normal fat planes and frank soft tissue masses in all six central skull base osteomyelitis patients. Signal intensity on T2-weighted images of the clivus was high in five central skull base osteomyelitis patients. With intravenous contrast, fascial plane anatomy appeared restored in central skull base osteomyelitis cases, almost in keeping with that of non-involved areas. This was not a feature in any of the malignant conditions.
中央颅底骨髓炎在临床上很难与恶性肿瘤区分开来。
将6例中央颅底骨髓炎患者的计算机断层扫描（CT）和磁共振成像（MRI）扫描结果与一系列颅底疾病患者的扫描结果进行比较。
相对于MRI的变化，中央颅底骨髓炎的CT扫描显示骨质破坏要少得多，而恶性肿瘤病例在CT和MRI上的骨质破坏相似。在MRI扫描中，可以证实先前关于斜坡相对于正常脂肪骨髓在T1加权图像上呈低信号强度的发现。此外，所有6例中央颅底骨髓炎患者均有斜坡前和斜坡旁软组织浸润的迹象，正常脂肪平面消失并出现明显的软组织肿块。5例中央颅底骨髓炎患者斜坡在T2加权图像上的信号强度较高。静脉注射造影剂后，中央颅底骨髓炎病例的筋膜平面解剖结构似乎恢复正常，几乎与未受累区域一致。这在任何恶性疾病中都不是一个特征。
