摘要
目的:研究翼腭窝(PPF)及其交通的解剖和病变影像特征。方法:4具尸体头颅冰冻切片与同层CT及MRI对照,1例行大体解剖;50例志愿者和79例患者分别行正常PPF和病变PPF影像检查。结果:PPF内充填脂肪,窝内神经、血管表现为低密度脂肪内点条状软组织密度影或高信号脂肪内稍低或流空信号。本组8例CT与5例MRI仅显示呈短条或斑点状的翼腭神经节的可疑影像。有3例4侧圆孔及9例16侧翼管走行于蝶窦内,1例1侧圆孔出颅后未汇入PPF而进入同侧翼板。翼腭管长度为(12.88±1.82)mm;79例病变中肿瘤71例(继发肿瘤69例),其中继发恶性肿瘤62例,浸润性破坏骨壁,直接或间接侵犯PPF,边界不清。12例继发恶性肿瘤致PPF扩大,其中鼻咽癌10例,PPF扩大程度较小且常伴骨壁的溶骨性破坏。原发性和继发性纤维血管瘤增强CT及T2WMRI显示边界清楚,PPF明显扩大,骨破坏呈压迫性。病变PPF内脂肪变模糊,部分或全部消失。1例鼻腔囊腺癌呈结节状神经周跳跃转移海绵窦及Meckel腔区。结论:PPF内充填脂肪,PPG影像难以清楚显示,翼腭管长度能在CT上测量,圆孔及翼管位置可变异;PPF病变以继发恶性肿瘤为主,窝内脂肪变模糊、消失常提示受侵。恶性肿瘤可使PPF稍扩大,也可沿交通内神经周转移。
Objective:To study the anatomy of PPF (pterygopalatine fossa) and its communication and the imaging features of diseases with CT and MRI.Methods:4 of 5 corpse heads were cross-sectioned and 1 was grossly anatomized. The normal PPF was studied in 50 volunteers,and pathological changes were observed in 79 cases of various diseases on CT and MRI.Results:PPF was filled with fat tissue,its nerves and blood vessels appeared as point or string-like soft tissue density shadows and low or flow void signal intensity.Pterygopalatine ganglion (PPG) was only shown as indefinite imaging in 8 cases on CT and 5 cases on MRI in this study.There were 4 foramen rotundums and 16 pterygoid canals running in sphenoid sinus,1 foramen rotundum going into the pterygoid plate.The length of pterygopalatine canal was 12.88±1.82mm.There were 71 cases of tumor (69 cases of secondary tumor) in 79 cases of PPF lesion,and 62 cases of secondary malignant tumor from the secondary tumors.The secondary malignant tumors usually infilitratively destructed the bony wall to involve PPF,the surrounding tissue and the fat within PPF were eroded,and usually poorly defined.There were 12 cases of secondary malignant tumors which slightly enlarged the PPF,destructed the bony wall.The primary benign tumors displaced and produced erosion on the bony wall obviously,enhanced CT and T2W MRI showed them well.The fat within the involved PPF was obliterated or replaced by soft tissue.1 case of adenoid cystic carcinoma extended perineurally and nodules were seen in Meckel cavity area.Conclusion:PPF was filled with fat tissue. PPG is difficult to show clearly on imaging.The length of the pterygopalatine canal can be measured on CT.The position of foramen rotundum and pterygoid canal may be variable.Secondary malignant tumors were the most common lesion of PPF,disappearance of the fat tissue was usually the susceptible sign,the perineural spread way was another characteristics,and sometimes they could also enlarge the PPF.
出处
《放射学实践》
2005年第7期578-582,共5页
Radiologic Practice
关键词
翼腭窝
解剖
体层摄影术
X线计算机
磁共振成像
Pterygopalatine fossa
Anatomy
Tomography,X-ray computed
Magnetic resonance imaging
