Lloyd G A, Lund V J, Phelps P D, Howard D J
Royal National Throat, Nose and Ear Hospital, London.
Br J Radiol. 1987 Oct;60(718):957-68. doi: 10.1259/0007-1285-60-718-957.
Fifty patients with a wide range of sinus disease have been examined by magnetic resonance. These included congenital conditions, inflammatory and allergic sinus disease, fungus infection, and both necrotising and non-necrotising granulomas. A variety of benign and malignant tumours have been investigated, including eight examples of juvenile angiofibroma and 19 malignant sinus tumours. This experience of magnetic resonance scanning has shown that it is superior to computed tomography in showing the extent of malignant disease and, provided the correct pulse sequences are employed, it is always possible to distinguish tumour from retained secretion or inflamed mucosa. The extent of intracranial invasion can also be optimally demonstrated. One of the advantages of the method is the direct three-plane imaging and multislice technique, which gives total coverage of the head and neck for the assessment of malignant disease. Tissue diagnosis in the paranasal sinuses is less important than the demonstration of tumour extent and distribution. Only one tumour (juvenile angiofibroma) showed diagnostic spin-sequence characteristics, and no differentiation was observed between malignant tumours of epithelial and mesenchymal origin. The major drawback of magnetic resonance is the poor demonstration of bone and calcification in the sinuses, so that in some patients the scans need to be augmented by computed tomography studies.
50例患有各种鼻窦疾病的患者接受了磁共振检查。这些疾病包括先天性疾病、炎性和过敏性鼻窦疾病、真菌感染以及坏死性和非坏死性肉芽肿。还对多种良性和恶性肿瘤进行了研究，包括8例青少年血管纤维瘤和19例恶性鼻窦肿瘤。磁共振扫描的经验表明，在显示恶性疾病的范围方面，它优于计算机断层扫描，并且只要采用正确的脉冲序列，总是能够将肿瘤与潴留的分泌物或发炎的黏膜区分开来。颅内侵犯的范围也能得到最佳显示。该方法的优点之一是直接的三平面成像和多层技术，这可为评估恶性疾病对头颈部进行全面覆盖。在鼻窦中，组织诊断不如显示肿瘤范围和分布重要。只有一种肿瘤（青少年血管纤维瘤）表现出诊断性的自旋序列特征，并且未观察到上皮源性和间叶源性恶性肿瘤之间的差异。磁共振的主要缺点是鼻窦内骨骼和钙化显示不佳，因此在一些患者中，需要通过计算机断层扫描研究来补充扫描结果。
