摘要
目的分析儿童鼻腔鼻窦恶性肿瘤及肿瘤样病变的CT和MRI特征,提高诊断准确性。资料与方法回顾性分析2014年8月—2021年1月深圳市儿童医院经病理诊断为鼻腔鼻窦恶性肿瘤及肿瘤样病变的29例患儿的临床及影像资料,观察病变的CT密度、MRI信号、强化情况以及邻近骨质改变等影像学表现。结果29例患者中,淋巴瘤7例、神经母细胞瘤骨转移6例、横纹肌肉瘤4例、白血病3例、朗格汉斯细胞组织细胞增生症(LCH)9例。4例神经母细胞瘤骨转移可见长条垂直骨针;2例白血病可见短粗骨针;3例横纹肌肉瘤可见粗大血管影,呈渐进性葡萄状强化;5例LCH骨质破坏呈纽扣征或火山口征。结论淋巴瘤、神经母细胞瘤骨转移、横纹肌肉瘤及白血病均为儿童鼻腔鼻窦常见恶性肿瘤,均有相对特异的影像学表现,软组织强化模式、骨质破坏形式及骨膜反应特点均为影像鉴别诊断关键点,同时需要与LCH进行鉴别。
Purpose To analyze and summarize the CT and MRI features of pediatric sinonasal malignancies and tumor-like lesions,in order to improve the diagnostic accuracy.Materials and Methods Clinical and imaging data of 29 children with sinonasal malignancies and tumor-like lesions confirmed by pathology from August 2014 to January 2021 in Shenzhen Children’s Hospital were retrospectively analyzed.The imaging characteristics were observed and analyzed mainly about CT density,MRI signal intensity,enhancement and bony change.Results Among the 29 patients,there were 7 cases of lymphoma,6 cases of neuroblastoma,4 cases of rhabdomyosarcoma,3 cases of leukemia,9 cases of Langerhans cell histiocytosis(LCH).Long sunburst periosteal reaction was found in 4 cases of neuroblastoma metastasis while stubbed periosteal proliferation was found in 2 cases of leukemia.3 cases of rhabdomyosarcoma showed large blood vessels and progressive enhancement with“botryoid sign”,and 5 cases of LCH had button-like or crater-like bone destructions.Conclusion Lymphoma,bone metastasis of neuroblastoma,rhabdomyosarcoma and leukemia are common pediatric malignancies in nasal cavity and sinus,possessing distinctive radiological features.The enhancement of mass,bony destruction and periosteal reaction are the key points of differential diagnosis,which should be distinguished from LCH.
作者
刘心怡
罗益镇
林洁琼
叶文宏
干芸根
曾洪武
LIU Xinyi;LUO Yizhen;LIN Jieqiong;YE Wenhong;GAN Yungen;ZENG Hongwu(Department of Radiology,Shenzhen Children's Hospital,Shenzhen 518038,China;不详)
出处
《中国医学影像学杂志》
CSCD
北大核心
2022年第5期451-456,共6页
Chinese Journal of Medical Imaging
基金
深圳市医疗卫生三名工程项目(SZSM202011005)。
