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目的探讨鼻腔及鼻窦内翻性乳头状瘤的CT和MRI表现特点。方法回顾性分析17例经手术病理证实的鼻腔及鼻窦内翻性乳头状瘤的CT和MRI资料,17例均行CT平扫及三位重建,7例行MRI平扫及增强。结果 17例均为单侧发病,累及鼻腔外侧壁2例,累及鼻腔及鼻窦15例,其中1例恶变为鳞癌。16例良性病灶呈条块状、菜花状,游离缘呈小波浪状,沿鼻固有结构匍匐生长;CT上病灶呈均匀的中等密度,骨质受压变形13例,局部骨质增生肥大5例,骨质吸收3例;中下鼻甲受压移位11例,上颌窦口开大5例;MRI上呈等T1、等-稍高混杂T2信号,不均匀强化,T2及增强T1呈栅栏状3例;呈等-低T1、等-高T2混杂信号、不均匀强化,T2和增强T1呈卷曲脑回状2例;等T1、等T2信号、中等均匀强化1例。1例恶变病例呈球形,边缘呈分叶状,可见骨质侵袭破坏,信号混杂,缺少栅栏状及卷曲脑回样强化。结论匍匐性膨胀性生长、小波浪状边缘是鼻腔及鼻窦内翻性乳头状瘤的形态特征,CT呈均匀软组织密度,常伴骨质受压改变,T2WI和增强T1WI呈栅栏状、卷曲脑回状是其典型MRI表现。骨质侵袭破坏,信号混杂,缺少栅栏状及卷曲脑回状强化提示恶性可能。
Objective To investigate CT and MRI features of inverted papilloma in nasal cavity and nasal cavity. Methods The CT and MRI data of 17 cases of nasal and sinus inverted papilloma confirmed by surgery and pathology were retrospectively analyzed. Seventeen patients underwent CT scan and three reconstruction, and 7 patients underwent MRI scan and MRI enhancement. Results All the 17 cases were unilateral disease, involving 2 cases of lateral nasal wall, involving 15 cases of nasal cavity and sinuses. One case of malignant transformation was squamous cell carcinoma. Sixteen cases of benign lesion appeared in the shape of a block with a cauliflower-like shape. The free edge showed a small wave shape and grew creeping along the nasal inherent structure. The lesions on CT showed a uniform medium density with 13 cases of bone compression deformation and 5 cases of local bone hyperplasia and hypertrophy , Bone resorption in 3 cases; middle and inferior turbinate compression displacement in 11 cases, 5 cases of maxillary sinus osseous enlargement; MRI showed equal T1, equal - slightly higher mixed T2 signal, uneven enhancement, T2 and enhanced T1 was palisading 3 cases were showed equal-low T1, high-T2 mixed signals, uneven enhancement, T2 and enhanced T1 were curly brain back in 2 cases; T1, T2 and other signals, moderately uniform in 1 case. One case of malignant transformation was spherical, the edge was lobulated, visible bone invasion and destruction, the signal mixed, the lack of palisading and curly brain back-like enhancement. Conclusions The creeping growth and small wavy edge are morphological characteristics of inverted papilloma in nasal cavity and paranasal sinuses. CT showed a uniform soft tissue density, often accompanied by changes in bone mass, T2WI and enhanced T1WI, The shape is its typical MRI appearance. Bone invasion and destruction, the signal mixed, the lack of fence-like and curly femoral back enhancement prompted malignant possible.