摘要
目的探讨颅面部骨化性纤维瘤的CT和MRI表现,提高其诊断准确性。方法回顾性分析经手术病理证实的15例颅面部骨化性纤维瘤患者的CT和MRI影像学资料。结果15例中病变起源于筛窦6例,额窦4例,蝶窦3例,额骨、上颌骨额突各1例;10例首发病例多呈卵圆形,形态规则,5例复发病例中4例形态不规整。CT表现:11例于骨窗上均呈密度不均匀的"磨玻璃"样略高密度或高密度肿块影(与脑实质比较),内部均可见大小不等的囊变区,1例伴点状更高密度钙化影,7例肿瘤周边可见特征性"蛋壳样"骨壳形成,其中5例于其内侧可见到环形或弧线形底密度影。MR表现:8例中,肿瘤实性部分于T1WI呈低信号1例,呈等信号7例;呈高信号1例,T2WI呈低信号7例(与脑灰质比较),其中4例混有片状高信号影;继发囊变者4例,T2WI均呈高信号,T1WI呈等信号、低信号各2例;增强后,实性部分呈中等度强化,囊变部分不强化,而囊壁及间隔明显强化。结论CT是颅面部骨化性纤维瘤的首选检查方法,尤其是CT骨窗对该病诊断价值较大,MRI表现也具有一定的特征,是一项重要的辅助检查手段,二者的联合应用可提高该肿瘤诊断的准确性。
Objective To investigate CT and MRI findings of ossifying fibroma of craniofacial region in order to improve the diagnostic accuracy. Methods CT and MRI data of 15 cases with ossifying fibroma of craniofacial region confirmed pathologically were analyzed retrospectively. Results Among the 15 cases, the lesions occurred in ethmoid sinus in 6 cases, in frontal sinus in 4 cases, in sphenoid sinus in 3 cases, in frontal bone in 1 case and in frontal process of maxila in 1 case. Ten cases which were first found showed regular oval shape, 4 of 5 recurred lesions appeared as irregular shape. On bone algorithm reconstruction of CT, 11 lesions revealed heterogenous ＂ground-glass like＂ mild hyperdensity or hyperdensity masses compared with brain tissue with cystic areas, stippled calfication was seen in 1 cases, the typical eggshell like bony capsule in 7 cases, 5 cases under it showed ring or arc hypodensity line. On MR T1WI, the solid segments of ossifying fibroma showed low signal intensity compared with brain grey matter in 1 case and intermediate signal intensity in 7 cases, on T2WI, the corresponding portions showed hyperintense signal in 1 case and hypointense signal in 7 cases, of which 4 cases scattered pitch like high signal intensity; 4 secondary cystic changes lesions revealed high signal intensity on T2WI, 2 lesions intermediate and low signal intensity on T1WI respectively. Postcontrast MR images demonstrated moderate intensity enhancement in solid segments in all lesions, cystic segments showed no enhancement but the cystic walls and septa significant enhancement. Conclusion CT is the modality of fist choice in diagnosis of ossifying fibroma of craniofacial region, especially, CT bone algorithm reconstruction is valuable to its final diagnosis, MRI, as a complemental imaging examination method, also has some characteristics, the combined application of both contributes to the improvemet of its diagnostic accuracy.
出处
《中国医学影像技术》
CSCD
北大核心
2007年第10期1461-1464,共4页
Chinese Journal of Medical Imaging Technology
