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目的探讨鼻窦海绵状血管瘤的 CT 和 MRI 表现,提高其诊断准确性。方法回顾性分析30例经病理证实的鼻窦海绵状血管瘤患者的影像资料。结果发生于上颌窦者25例,前组筛窦3例,蝶窦2例。30例均可见病变向邻近的部位蔓延,压迫相应结构,但分界尚清楚,MRI 较 CT 显示更清楚。CT 表现为受累的鼻窦均有不同程度的扩大,窦壁骨质受压、变形,28例骨质不连续并形成缺损,以上颌窦内壁最常见(21例),残端骨质伴硬化8例,内可见软组织肿块影,边界清楚,密度不均匀,其中10例见静脉石影;16例增强后呈明显不均匀强化,内有散在、形态不一的明显强化区域。与脑组织比较病变在 MR T_1WI 呈低信号4例,中等信号14例;在 T_2WI 呈高信号16例,中等信号2例,但信号不均匀,其内可见形态及数量不一的低信号影;增强后病变呈显著不均匀强化,外观呈蜂窝状8例,斑驳状10例;8例动态增强扫描均显示渐进性强化。结论典型骨质改变加静脉石可提示该病诊断;MR T_2WI 不均匀高信号、渐进性强化、斑驳状或蜂窝状表现,也是诊断该病的特征性征象;联合使用 CT 和 MRI 可为该病诊断和治疗提供更准确、可靠的信息。
Objective To investigate the CT and MRI manifestations of cavernous hemangiomas and to improve the diagnostic accuracy. Methods A retrospective analysis of 30 cases of pathologically confirmed cavernous hemangioma in patients with imaging data. Results 25 cases occurred in the maxillary sinus, the anterior ethmoid sinus in 3 cases, 2 cases of sphenoid sinus. All of the 30 cases showed that the lesions spread to adjacent parts and oppression of the corresponding structures, but the boundaries were still clear. MRI showed more clearly than CT. CT showed involvement of the sinus have different degrees of expansion, sinus wall compression, deformation, 28 cases of bone discontinuity and the formation of defects, the most common sinus wall (21 cases), stump with hardening of the 8 Cases, soft tissue mass visible within the shadow, the border is clear, the density is not uniform, of which 10 cases of venous stone shadow; 16 cases were significantly enhanced after the uneven enhancement, there are scattered, scattered areas of distinct enhancement. Compared with the brain tissue lesions in MR T_1WI showed low signal in 4 cases, 14 cases of moderate signal; T_2WI showed high signal in 16 cases, 2 cases of moderate signal, but the signal is not uniform, which can be seen in the shape and quantity of low signal shadow; After the enhancement, the lesions were significantly unevenly enhanced, the appearance of honeycomb in 8 cases, mottled in 10 cases; 8 cases of dynamic contrast-enhanced scanning showed progressive enhancement. Conclusion The typical changes of the bone and veins can be diagnosed. MR T_2WI uneven high signal, progressive enhancement, mottled or honeycomb appearance are also the characteristic signs of the diagnosis of the disease. The combined use of CT and MRI can be the disease Diagnosis and treatment provide more accurate and reliable information.