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目的评价常规MRI及动态增强联合表观扩散系数对筛窦腺癌的诊断价值。方法回顾性分析8例经手术病理证实的筛窦腺癌的MRI及动态增强征象。8例均行常规MRI和MR动态增强扫描,后处理得到TIC曲线及半定量参数SI_(pre)、SI_(max)、SI_(peak)、T_(peak)、MSI;8例均行MR DWI检查,测量病变实性部分ROI内的表观扩散系数值。结果常规MRI表现:8例均表现为筛窦软组织肿块,呈等、稍长T_1WI及等T_2WI信号,累及眼眶骨壁4例,眼前部内容物1例,累及蝶窦1例,累及鼻部皮肤2例。MRI动态增强表现:8例病变均明显强化,TIC曲线整体呈速升-平缓型,SI_(pre)平均值为20,SI_(max)平均值为962.5,SI_(peak)平均值为867.3,T_(peak)平均为第5个时相,MSI平均值为42.4%。表观扩散系数平均值为1.16×10~(-3)mm~2/s。结论 MRI及动态增强联合表观扩散系数有利于筛窦腺癌的定位、定性诊断。
Objective To evaluate the diagnostic value of routine MRI and dynamic enhancement combined with apparent diffusion coefficient in diagnosis of ethmoid adenocarcinoma. Methods Retrospective analysis of 8 cases of pathologically confirmed ethmoid adenocarcinoma MRI and dynamic enhancement signs. All 8 patients underwent routine MRI and MR dynamic contrast-enhanced scanning. The TIC curve and semi-quantitative parameters SI pre, SI max, SI peak, T peak and MSI were obtained after treatment. All 8 patients underwent MR DWI , Measuring the apparent fraction of diffusion coefficient within the ROI of the solid part of the lesion. Results The routine MRI findings showed that all the 8 cases showed ethmoid sinus soft tissue mass with equal and slightly longer T_1WI and T_2WI signals, including 4 cases of orbital wall, 1 case of anterior eye and 1 case of sphenoid sinus involving the nasal skin 2 cases. MRI dynamic enhancement: all 8 lesions were significantly enhanced, TIC curve showed the general ascending - flat, SI pre average 20, SI max average 962.5, SI peak average 867.3, T_ (peak) averaged the 5th phase and the MSI averaged 42.4%. The average apparent diffusion coefficient is 1.16 × 10 ~ (-3) mm ~ 2 / s. Conclusion MRI and dynamic enhancement combined with apparent diffusion coefficient are helpful for the localization and qualitative diagnosis of ethmoid sinus adenocarcinoma.