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目的探讨鼻腔鼻窦炎性肌纤维母细胞瘤的CT与MRI表现。方法回顾性分析16例经手术病理证实的鼻腔鼻窦炎性肌纤维母细胞瘤的CT与MRI资料,其中9例行CT平扫,15例行MRI常规平扫和增强扫描,8例同时行MRI动态增强扫描。结果发生于上颌窦11例,筛窦2例,鼻前庭2例,上颌骨颧突1例;10例表现为不规则肿块,6例沿窦壁浸润性生长。CT表现:与脑实质相比,病变呈等密度5例,不均匀略低密度4例;受累窦壁骨质破坏伴残端骨质硬化6例,硬化肥厚1例,骨质破坏伴瘤骨1例。MRI表现:与脑实质相比,T1WI呈等信号,T2WI呈不均匀信号;主体呈低信号6例,等信号7例,高信号2例;增强扫描病变呈明显强化13例,中等强化2例。8例动态增强扫描的时间-信号强度曲线为速升缓降型。蔓延至邻近结构:翼腭窝、颞下窝11例,眼眶9例,面颊部皮下组织5例,鼻腔4例。结论骨质破坏伴残端骨质硬化,T2WI呈低或等信号,MRI明显强化和速升缓降型时间-信号强度曲线是鼻腔鼻窦炎性肌纤维母细胞瘤的较具特征性表现。
Objective To investigate CT and MRI findings of nasal sinusitis myofibroblastoma. Methods CT and MRI data of 16 cases of nasal sinusitis myofibroblastoma confirmed by surgery and pathology were retrospectively analyzed. Among them, 9 cases underwent CT scan, 15 cases underwent conventional MRI and enhanced scan, and 8 cases underwent MRI dynamic Enhanced scanning. The results occurred in 11 cases of maxillary sinus, ethmoid sinus in 2 cases, nasal vestibule in 2 cases, maxillary zygomatic process in 1 case; 10 cases showed irregular mass, 6 cases along the sinus wall invasive growth. CT manifestations: Compared with the brain parenchyma, the lesion showed an isodense density in 5 cases and a non-uniform slightly low density in 4 cases. Six cases suffered from bone destruction of the sinus wall accompanied with stump cataract, 1 case of sclerosis and hypertrophy, 1 case. MRI manifestations: compared with the brain parenchyma, T1WI was equal signal, T2WI was uneven signal; the main body was low signal in 6 cases, equal signal in 7 cases, high signal in 2 cases; enhanced scan lesions were significantly enhanced in 13 cases, moderate enhancement in 2 cases . Eight cases of dynamic contrast-enhanced scan time-signal intensity curve for the type of slow down. Spread to the adjacent structures: pterygopalatine fossa, infratemporal fossa in 11 cases, 9 cases of orbital, subcutaneous tissue in the cheek 5 cases, 4 cases of nasal cavity. Conclusions The bone destruction with residual cortical bone sclerosis and T2WI showed low or equal signal. The obvious enhancement of MRI and the ascending - descending time - signal intensity curve were the characteristic features of nasal sinusitis myofibroblastoma.