Chang Sha, Zheng Xing, DU Xia, Song Lingling, Deng Qiong, Han Mi, Jia Yao
Department of Radiology,the Affiliated Hospital of Guizhou Medical University,Guiyang,550004,China.
Department of Radiology,the Beijing Jishuitan Hospital Guizhou Hospita.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Jul;38(7):578-583;588. doi: 10.13201/j.issn.2096-7993.2024.07.004.
To explore the imaging features of rare tumors of nasal cavity and sinuses, and to improve the understanding of these diseases, thereby aiding clinical diagnosis and treatment. The CT and MRI findings of 79 cases of rare neoplasm of nasal cavity and sinuses confirmed by pathology were retrospectively analyzed, and the imaging features were summarized. Among the 79 cases, there were 16 cases of neuroendocrine carcinoma, most showing expansive and infiltrative bone destruction without hyperosteogeny and sclerosis. The sphenoid sinus exhibited a "pigeon" shape. In 28 cases of malignant melanoma, MRI signals were diverse, typical signals were rare, but mixed signals were more common. In 12 cases of rhabdomyosarcoma, MRI enhancement mostly showed "grape-like" enhancement and partial ring enhancement; There were 10 cases of olfactory neuroblastoma, the lesions were consistent with the distribution area of olfactory mucosa, most of them were lobulated, marginal nodules, and "flower ring" enhancement, and 2 cases grew across intracranial and external, with multiple cystic lesions and surrounding flaky edema bands. In 5 cases of solitary fibrous tumor, Benign tumors had regular shape and uniform density, while malignant tumors had irregular shape and uneven density, The enhancement was obviously uneven and showed a "pattern" change. There were 2 cases of sarcomatoid carcinoma, both with lobed appearance, uneven density, lamellar low-density shadow, and osteolytic bone destruction. In 4 cases of schwannoma, the enhancement showed obvious inhomogeneous enhancement. One case showed cystic necrosis, one case showed calcification, and the surrounding structure was compressed without damage. There was 1 case of neurofibroma, with many cystic components, low signal separation and compartmentalized enhancement. One case of paraganglioma showed moderate enhancement in the arterial phase and progressive enhancement in the venous phase, accompanied by significant swelling bone destruction. Rare tumors of nasal cavity and paranasal sinuses have distinctive imaging features. CT and MRI can effectively show the extent of the lesions and the degree of infiltration into adjacent tissues and organs, which is helpful for early clinical diagnosis and staging. However, definitive diagnosis still depends on pathology and immunohistochemistry.
探讨鼻腔鼻窦罕见肿瘤的影像学特征,提高对这些疾病的认识,从而辅助临床诊断与治疗。回顾性分析79例经病理证实的鼻腔鼻窦罕见肿瘤的CT及MRI表现,总结其影像学特征。79例中,神经内分泌癌16例,多表现为膨胀性及浸润性骨质破坏,无骨质增生及硬化,蝶窦呈“鸽形”。恶性黑色素瘤28例,MRI信号多样,典型信号少见,混合信号多见。横纹肌肉瘤12例,MRI增强多表现为“葡萄样”强化及部分环形强化;嗅神经母细胞瘤10例,病变与嗅黏膜分布区域相符,多呈分叶状、边缘结节状,呈“花环样”强化,2例跨颅内、外生长,有多个囊变区及周围片状水肿带。孤立性纤维瘤5例,良性肿瘤形态规则、密度均匀,恶性肿瘤形态不规则、密度不均匀,增强明显不均匀,呈“地图样”改变。肉瘤样癌2例,均呈分叶状,密度不均匀,有片状低密度影,骨质呈溶骨性破坏。神经鞘瘤4例,增强呈明显不均匀强化,1例有囊变坏死,1例有钙化,周围结构受压但无破坏。神经纤维瘤1例,有多个囊变成分,呈低信号分隔,呈分隔样强化。副神经节瘤1例,动脉期呈中度强化,静脉期呈渐进性强化,伴有明显骨质膨胀性破坏。鼻腔鼻窦罕见肿瘤具有独特的影像学特征。CT及MRI能有效显示病变范围及对相邻组织器官的浸润程度,有助于临床早期诊断及分期。然而,确诊仍依赖于病理及免疫组化。