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目的:探讨上颌窦出血性息肉的CT、MRI表现,总结影像学特点,为临床诊断提供帮助。方法:回顾性分析27例经手术病理证实的上颌窦出血性息肉CT、MRI影像学资料。针对病变部位、形状、范围,窦壁骨质改变,病变边缘及周围结构情况,病变密度或信号,各期增强扫描的强化方式、幅度及范围进行统计分析。结果:27例患者均为单侧发病。均行CT平扫,其中9例行双期动态增强CT检查,11例行MRI检查,其中6例行MRI增强检查。CT平扫见单侧上颌窦充满等低混杂密度影并累及鼻腔,上颌窦不均匀膨大变形,伴局部骨质吸收破坏27例,但未侵犯邻近结构,CT增强扫描病变内见点片状血管样显著强化及进行性强化。MRI能清楚区分病变及阻塞性鼻窦炎,病变均形态不规则,呈混杂信号,T1WI主要为中等信号8例、稍低信号3例,混杂少量高信号;T2WI呈高低混杂信号,边缘见不规则低信号环。增强呈多发结节状、斑片状不均匀明显强化。结论:上颌窦出血性息肉CT显示实变上颌窦不规则膨大变形伴骨质压迫吸收对本病有一定提示作用,血管样显著强化及进行性强化是本病的特征性增强CT表现,MRI具有非常典型的影像学表现,T2WI呈高低混杂信号和低信号环,增强呈多发结节状、斑片状不均匀明显强化,能清楚地显示病变与周围软组织无侵犯征象。具有较好的诊断价值。术前CT和MRI检查对该病的术前诊断有重要意义。
Objective: To investigate the CT and MRI findings of maxillary sinus hemorrhagic polyps and to summarize the imaging features of the polyps for the clinical diagnosis. Methods: A retrospective analysis of 27 cases of pathologically confirmed maxillary sinus bleeding CT, MRI imaging data. For the lesion, shape, range, sinus wall bone changes, the edge of the lesion and the surrounding structure, lesion density or signal, enhanced scan enhanced pattern, amplitude and range for statistical analysis. Results: All 27 patients were unilateral disease. CT scan was performed in 9 cases, double-phase dynamic contrast-enhanced CT in 11 cases, MRI in 11 cases, and enhanced MRI in 6 cases. CT plain scan showed unilateral maxillary sinus filled with low and other mixed density shadow and involving the nasal cavity, maxillary sinus uneven deformation, with the destruction of the local bone absorption in 27 cases, but did not infringe adjacent structures, CT enhanced lesion see flaky vessels Significantly enhanced and progressive strengthening. MRI can clearly distinguish between lesions and obstructive sinusitis, the lesions are irregular in shape, showing mixed signals, T1WI is mainly moderate signal in 8 cases, slightly lower signal in 3 cases, mixed with a small amount of high signal; T2WI was mixed signal of high and low, the edge see irregular Low signal loop. Enhanced nodules were multiple, patchy uneven significantly enhanced. Conclusion: Maxillary sinus hemorrhagic polyp CT showed solidified maxillary sinus irregular enlargement with bone resorption has some tips on the disease, vascular-like enhancement and progressive enhancement of the disease is characterized by enhanced CT manifestations, MRI has Very typical imaging findings, T2WI showed mixed signal and low signal loop, increased nodules were nodular, patchy uneven significantly enhanced, can clearly show the lesions and surrounding soft tissue no signs of invasion. Has a good diagnostic value. Preoperative CT and MRI examination of the disease preoperative diagnosis of great significance.