摘要
目的分析原发鼻腔鼻窦结外鼻型NK/T细胞淋巴瘤(ENKTCL)的CT和MRI表现,以提高诊断的准确性。方法回顾性分析2018年1月至2021年12月安徽医科大学附属阜阳医院放射科的9例原发鼻腔ENKTCL的临床病历资料及影像学检查资料,分析CT及MRI平扫、增强的影像学特点。结果5例患者CT平扫的软组织窗可见鼻腔鼻窦内软组织密度影,密度相对均匀,主要位于鼻腔中线及鼻窦区域。5例患者中3例误诊为鼻窦炎,1例提示占位,1例为术后复查。5例患者的CT图像在骨窗均可清楚显示病变侵及骨质破坏的范围。8例患者的MRI图像中,肿瘤在T1WI为等信号,T2WI呈稍高信号,增强后病变为轻到中度的不均匀强化;其中2例考虑内翻性乳头状瘤,3例诊断淋巴瘤,3例为手术及放疗后复查。术前及治疗前同时做过CT和MRI平扫及增强只有两例,其中1例先做CT,报告只提示鼻窦炎,MRI增强不能除外淋巴瘤;另外一例先做CT增强提示淋巴瘤可能,次日MRI也提示符合淋巴瘤表现。结论原发于鼻腔鼻窦ENKTCL的早期诊断比较困难,常规行CT和MRI增强检查对诊断及鉴别诊断淋巴瘤具有很大价值,对于准确判断病变范围、骨质破坏情况及评估疾病预后具有重要意义。
Objective To analyze the CT and MRI findings of primary nasal extranodal nasal NK/T cell lymphoma(ENKTCL)in order to improve the diagnostic accuracy.Methods Clinical medical records and imaging data of 9 cases with primary nasal ENKTCL in the Department of Radiology,Fuyang Hospital Affiliated to Anhui Medical University from January 2018 to December 2021 were retrospectively analyzed,and the imaging features of CT and MRI plain scan and enhanced scan were analyzed.Results The soft tissue density in the nasal sinuses was relatively uniform in the soft tissue window of CT scan in 5 patients,mainly located in the middle line of the nasal cavity and the sinus area.Of the 5 patients,3 were misdiagnosed as sinusitis,1 indicated space occupation,and 1 was revisited after surgery.CT images of 5 patients can clearly show the extent of lesion invasion and bone destruction in bone window.In the MRI images of 8 patients,the tumors showed equal signal on T1WI,slightly higher signal on T2WI,and the lesions showed mild to moderate uneven enhancement after enhancement.Of these,2 cases were considered for varus papilloma,3 cases were diagnosed with lymphoma,and 3 cases were re-examined after surgery and radiotherapy.Preoperative and pre-treatment CT and MRI plain scan and enhancement were performed in only two cases,among which 1 case underwent CT first,and the report only indicated sinusitis,and MRI enhancement could not exclude lymphoma.In the other case,CT enhancement first indicated the possibility of lymphoma,and MRI the next day also indicated the appearance of lymphoma.Conclusion The early diagnosis of ENKTCL in the nasal cavity and sinuses is difficult,and routine CT and MRI enhanced examination is of great value in the diagnosis and differential diagnosis of lymphoma,which is of great significance for accurately judging the lesion scope,bone destruction and evaluating the prognosis of the disease.
作者
沈中原
王嫚
李飞
张小艳
阚宏
Shen Zhong-yuan;Wang Man;Li Fei;Zhang Xiao-yan;Kan Hong(Department of Radiology,Fuyang Hospital,Anhui Medical University,Fuyang 236000,Anhui Province,China;Nuclear medicine discipline of Fuyang Hospital affiliated to Anhui Medical University,Fuyang 236000,Anhui Province,China)
出处
《中国CT和MRI杂志》
2023年第8期34-36,共3页
Chinese Journal of CT and MRI
基金
中国红十字会基金(XN-HR-YXFN-2021-05-24)。
