额窦原发恶性肿瘤的CT和MRI表现

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摘要目的：探讨原发于额窦恶性肿瘤的CT及MRI表现，以提高对本病的认识。方法：回顾性分析14例经活检或手术病理证实的额窦原发恶性肿瘤患者的临床和影像学资料，病理类型包括鳞癌5例，浆细胞瘤3例，恶性黑色素瘤2例，横纹肌肉瘤、骨肉瘤、小细胞癌、间叶来源恶性肿瘤各1例。6例行CT平扫，2例行平扫+增强CT扫描，4例行增强CT扫描，13例行MR扫描，5例加DWI序列。结果：11例肿块位于左侧额窦，2例位于右侧额窦，1例位于双侧额窦，侵犯眶壁14例，侵入眶内7例，侵犯筛窦10例、对侧额窦3例、前颅底10例、额部皮下7例。CT平扫时肿块均呈中等密度，增强扫描4例呈不均匀强化，2例均匀强化，破坏额窦下壁（眶内上壁）14例、后壁12例、前壁7例。MR T2WI上，10例呈等或稍高信号，其中4例伴有小片高信号、2例伴局部低信号、2例呈等高混杂信号、1例呈略低信号，增强后10例肿块呈不均匀强化，3例呈均匀强化，4例扩散受限，1例轻度扩散受限。结论：原发于额窦的恶性肿瘤常见的为鳞癌、浆细胞瘤和黑色素瘤，额窦下壁和后壁常呈侵蚀性吸收破坏，肿块易侵犯同侧眼眶、前组筛窦和前颅底，DWI扩散受限是其影像学上的重要征象，浆细胞瘤和恶性黑色素瘤信号有一定特征。

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	潘宇澄
	黄文虎

关键词 ：鼻窦肿瘤；体层摄影术, X线计算机；磁共振成像

Abstract：Objective: To explore the CT and MRI findings of the primary malignant tumors of the frontal sinus, in order to improve the clinic diagnosis of these diseases. Methods: The imaging data of 14 patients with pathologically proved malignant tumors were analyzed retrospectively, including 5 squamous carcinomas(one of which cancerated from inverted papilloma), 3 plasmocytomas, 2 melanomas, 1 rhabdomyosarcoma, 1 small cell carcinoma, 1 osteosarcoma and 1 mesenchymal sarcoma. Eight patients underwent plain CT, 6 patients underwent enhanced CT scan, and 13 patients underwent MRI examinations. Results: Eleven lesions originated from the left frontal sinus, 2 lesions from the right, while one from bilateral sinuses. The lesions invaded orbit walls in 14 cases, ethmoid sinuses in 10 cases, forehead in 7 cases, anterior cranial fossa in 10 cases and contralateral frontal sinus in 3 cases. One lesion was a regular nodule, while the other 13 lesions were irregular or diffused. On plain CT of 8 cases, tumors showed isointensity. After contrast enhancement, four masses were heterogeneously enhanced and two were homogenously enhanced. The tumors eroded the anterior walls of frontal sinus in 7 cases, the posterior walls in 12 cases and inferior walls in 14 cases. On T2WI of MRI, 10 masses showed isointense or slightly hyperintense signal, 2 masses showed mixed isointense and hyperintense signal, 1 mass showed slightly hypointense signal. After contrast enhancement, 10 lesions showed heterogeneous enhancement on T1WI images, three plasmocytomas showed homogenous enhancement. Four masses showed limited diffusion on DWI, and one showed slightly limited diffusion. Conclusion: The most common malignant tumors that originate from frontal sinuses are squamous carcinoma, plasmocytoma and melanoma. The posterior and inferior walls of the frontal sinuses are eroded in most cases. Most lesions invade to the outside of the sinuses, including orbits, ethmoid sinuses and anterior cranal fossae. The masses show limited diffusion on DWI. Plasmocytoma and melanoma have some characteristic MR signals. Combining CT and MRI images is helpful to confirm the characters and ranges of the lesions.

Key words： Paranasal sinus neoplasms Tomography, X-ray computed Magnetic resonance imaging

收稿日期: 2016-05-10

PACS:	Ｒ739.62
	Ｒ814.42
	Ｒ445.2

通讯作者: 黄文虎，复旦大学附属眼耳鼻喉科医院放射科，200031。E-mail：wenhuhuang@126.com

作者简介: 潘宇澄（1971-），男，江苏盐城人，副主任医师。E-mail：panyuchengg@sina.com

引用本文:

潘宇澄，黄文虎. 额窦原发恶性肿瘤的CT和MRI表现[J]. 中国临床医学影像杂志, 2016, 27(12): 855-858.
PAN Yu-cheng, HUANG Wen-hu. Imaging findings of malignant tumors originated from frontal sinuses. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(12): 855-858.

链接本文:

http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2016/V27/I12/855

[1]Frazell EL, Lewis JS. Cancer of the nasal cavity and accessory sinuses. A report of the management of 416 patients [J]. Cancer, 1963, 16(10): 1293-1301.
[2]Gerlinger I, Gobel G, Tóth E, et al. Primary carcinoma of the frontal sinus: a case report and a review of literature[J]. Eur Arch Otorhinolaryngol, 2008, 265(5): 593-597.
[3]Reddy KT, Gilhooly M, Wallace M, et al. Frontal sinus carcinoma presenting as acute sinusintis[J]. J Laryngol Otol, 1991, 105(2): 121-122.
[4]Dulguerov P, Jacobsen MS, Allal AS, et al. Nasal and paranasal sinus carcinoma: are we making progress? A series of 220 patients and a systematic review[J]. Cancer, 2001, 92(12): 3012-3029.
[5]Yoshida N, Kanekura T, Hashiguchi T, et al. Primary squamous cell carcinoma of the frontal sinus[J]. J Dermatol, 2006, 33(12): 855-857.
[6]Brownson RJ, Ogura JH. Primary carcinoma of the frontal sinus[J]. Laryngoscope, 1971, 81(1): 71-89.
[7]Hosokawa S, Okamura J, Sakai N, et al. Primary spindle cell carcinoma of the frontal sinus[J]. J Oral Maxillofac Surg, 2012, 70(11): 674-678.
[8]Wadhera R, Gulati SP, Garg A, et al. Primary adenocarcinoma of the frontal sinus[J]. Ear Nose Throat J, 2011, 90(10): 23-25.
[9]Abrahao M, Goncalves AP, Yamashita R, et al. Frontal sinus adenocarcinoma[J]. Sao Paulo Med J, 2000, 118(4): 118-120.
[10]Lewis JS, Castro EB. Cancer of the nasal cavity and paranasal sinuses[J]. J Laryngol Otol, 1970, 80(4): 274-284.
[11]王小婷，时光刚，刘亦青，等. 鼻腔鼻窦肿瘤临床特征和病理组织学特点的分析[J]. 临床耳鼻咽喉头颈外科杂志，2011，25（23）：1071-1075.
[12]Ichinose T, Goto T, Motomura H, et al. Primary squamous cell carcinoma of the frontal sinus treated with en bloc resection: case report[J]. Neurol Med Chir, 2009, 49(10): 481-483.
[13]黄向阳，符丹卉，苏丹柯，等. 髓外浆细胞瘤的影像学表现及鉴别诊断[J]. 广西医科大学学报，2013，30（3）：389-391.
[14]宋乐，杨本涛，陈光利，等. 鼻腔鼻窦横纹肌肉瘤的CT和MRI诊断[J]. 中国医学影像技术，2008，24（3）：366-369.
[15]梁丽宁，成官迅，黎蕾，等. 骨肉瘤X线、CT和MRI诊断分析[J]. 中国CT和MRI杂志，2009，7（3）：64-67.
[16]马婉玲，徐俊卿，葛雅丽，等. 骨肉瘤的MRI及DWI表现[J]. 实用放射学杂志，2008，24（4）：516-518.
[17]潘宇澄，沙炎，叶昕裴，等. 鼻腔鼻窦恶性纤维组织细胞瘤的CT和MRI表现[J]. 中国临床医学影像杂志，2012，23（2）：108-111.