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目的分析副鼻窦腺泡型横纹肌肉瘤(ARMS)的CT、MRI表现,探讨其诊断要点。方法经手术病理证实的4例ARMS患者,其中男性3例,女性1例;年龄分别为3、9、15、17岁,平均年龄11岁。所有患者均行MRI平扫及增强扫描,同时行CT平扫扫描。分析其影像特点。结果肿瘤位于蝶窦1例,筛窦2例,上颌窦1例。3例骨破坏呈膨胀性、吸收性,1例骨破坏呈溶骨性。累及翼腭窝1例,颞下窝2例,眼下直肌受累3例,鼻腔受累3例。直径<5 cm呈椭圆形,直径>6 cm呈不规则分叶状。2例有囊变密度或信号,无钙化,1例含有黏液蛋白成分。T1WI以稍低信号为主,近似或低于正常脑实质信号,T2WI以不均匀高信号为主,与脑脊液信号近似,增强扫描呈中等~明显强化,强化不均匀,但程度较轻,可见线环状及菊花瓣样强化。结论 ARMS的CT和MRI有一定的特征性表现,在鉴别诊断上有着较高的临床应用价值。
Objective To analyze the CT and MRI findings of paranasal sinuses acinar rhabdomyosarcoma (ARMS) and discuss the main points of diagnosis. Methods Four cases of ARMS confirmed by surgery and pathology, including 3 males and 1 females, were aged 3, 9, 15 and 17 years with a mean age of 11 years. All patients underwent MRI plain scan and enhanced scan, while CT scan. Analyze its image characteristics. Results The tumor was located in sphenoid sinus in 1 case, ethmoid sinus in 2 cases and maxillary sinus in 1 case. Three cases of bone destruction showed swelling, absorption, bone destruction was osteolytic in one case. Involved in pterygopalatine fossa in 1 case, infratemporal fossa in 2 cases, 3 cases of immediate rectus involvement, nasal involvement in 3 cases. Diameter <5 cm oval, diameter> 6 cm irregular lobulated. Two patients had cystic densities or signals without calcification, and one had mucinous protein components. T1WI is slightly lower signal, similar to or lower than normal brain parenchyma signal, T2WI with uneven high signal, and CSF signal approximation, enhanced scan was moderate ~ significantly enhanced uneven enhancement, but to a lesser extent, visible line Annular and chrysanthemum petal-like enhancement. Conclusion CT and MRI of ARMS have certain characteristic manifestations, and have high clinical value in differential diagnosis.