Rodriguez Diana P, Orscheln Emily S, Koch Bernadette L
From the Department of Radiology, Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH 43205 (D.P.R.); and Department of Radiology, Cincinnati Children's Hospital, Cincinnati, Ohio (E.S.O., B.L.K.).
Radiographics. 2017 Oct;37(6):1704-1730. doi: 10.1148/rg.2017170064.
A wide range of masses develop in the nose, nasal cavity, and nasopharynx in children. These lesions may arise from the nasal ala or other structures of the nose, including the mucosa covering any surface of the nasal cavity, the cartilaginous or osseous portion of the nasal septum, the nasal turbinates, and the nasal bones. Lesions may also arise from the nasopharynx or adjacent structures and involve the nose by way of direct extension. The causes of nasal masses in children include congenital and developmental disorders such as congenital nasolacrimal duct mucocele, dermoid cyst, cephalocele, and nasal neuroglial heterotopia; inflammatory and infectious processes such as mucocele, polyp, and pyogenic granuloma; benign neoplasms such as infantile hemangioma and juvenile nasopharyngeal angiofibroma; malignant lesions such as rhabdomyosarcoma and nasopharyngeal carcinoma; and masses related to prior trauma such as septal hematoma. Although direct visualization, without imaging, is frequently sufficient to diagnose pediatric nasal conditions, in many cases imaging has a key role in the treatment of the affected child. Some of these lesions have characteristic computed tomography and/or magnetic resonance imaging findings, some of them are diagnosed on the basis of the location and imaging findings combined, and others demonstrate nonspecific imaging findings. However, imaging is important for better defining the total extent of the lesion and guiding the clinician in determining whether medical and/or surgical intervention is required. In this article, the authors review the imaging findings of the most common causes-and many of the not-so-common causes-of nasal masses encountered in the pediatric population. RSNA, 2017.
儿童的鼻子、鼻腔和鼻咽部会出现各种各样的肿物。这些病变可能起源于鼻翼或鼻子的其他结构,包括覆盖鼻腔任何表面的黏膜、鼻中隔的软骨或骨质部分、鼻甲以及鼻骨。病变也可能起源于鼻咽部或相邻结构,并通过直接蔓延累及鼻子。儿童鼻肿物的病因包括先天性和发育性疾病,如先天性鼻泪管黏液囊肿、皮样囊肿、脑膨出和鼻神经胶质异位;炎症和感染性病变,如黏液囊肿、息肉和化脓性肉芽肿;良性肿瘤,如婴儿血管瘤和青少年鼻咽血管纤维瘤;恶性病变,如横纹肌肉瘤和鼻咽癌;以及与既往创伤相关的肿物,如鼻中隔血肿。虽然在许多情况下,不借助影像学检查仅凭直接观察就足以诊断儿童鼻部疾病,但在很多病例中,影像学检查在患儿的治疗中起着关键作用。其中一些病变有特征性的计算机断层扫描(CT)和/或磁共振成像(MRI)表现,一些病变是根据位置和影像学表现综合诊断的,还有一些病变表现为非特异性的影像学表现。然而,影像学检查对于更好地明确病变的整体范围以及指导临床医生确定是否需要进行药物和/或手术干预很重要。在本文中,作者回顾了儿科人群中常见以及许多不太常见的鼻肿物病因的影像学表现。RSNA,2017年