论著-头颈部
原发咽旁间隙肿瘤 的MRI表现与病理对 照研究*
作者:胡春淼 陈韵彬 曹喜生 何庄贞 岳秋园 方燕红 林 蓉
所属单位:福建省肿瘤医院,福建医科大学附 属肿瘤医院放射科 (福建 福州 350014)
PDF摘要
目的 通过对咽旁间隙肿瘤的MRI 及病理对照研究,提高咽旁间隙肿瘤的诊 断价值。方法 从2006年6月至2016年12 月,回顾性分析33例咽旁间隙肿瘤患者, 包括4例多形性腺瘤,4例神经鞘瘤,1例 颈动脉体瘤,1例副神经节瘤,血管瘤2 例,癌在多形性腺瘤中3例,多形性腺癌 1例,淋巴瘤4例,浆细胞瘤1例,腮腺癌 2例,腮腺腺样囊性癌2例,腮腺腺泡细 胞癌1例,恶性神经鞘瘤1例,滑膜肉瘤2 例,横纹肌肉瘤1例,粘液腺癌1例,低分 化腺癌1例,血管外皮肉瘤1例。所有33例 患者术前均行MRI平扫,其中32例患者进 行MRI平扫加多期增强MRI影像特征与组织 病理学结果进行对照,应用X2分析检验诊 断的准确性。结果 常规MRI、常规MRI加 多期增强MR影像特征与组织病理学结果, 整体符合率分别为51.5%,78.1%。结论 常规磁共振成像、多期增强MRI联合应用 可以提高咽旁间隙肿瘤诊断与鉴别诊断水 平。
Objective To evaluate the correlations between MRI manifestations of parapharyngeal space neoplasmsand its pathological findings,and, and to improve diagnostic levels. Methods Thirty-three patients (male [n=19], female [n=14]) with with tumors in the parapharyngeal space were retrospectively evaluated during this study from June 2006 to May 2013. All the patients have pathological diagnosis and were examined by MRI.In all the 33cases, 4 tumors were pleomorphic adenoma,8 tumors were schwannoma, 1 tumor was carotid body tumor, I tumor was Paraganglioma, 2 tumors were Angioma, 3 tumors were carcinoma in pleomorphic adenoma, 1 tumor was pleomorphic adenocarcinoma, 1 tumor was lymphoma, 1 tumor was plasmacytoma, 2 tumors wereparotid gland carcinoma, 2 tumors wereadenoid cystic carcinoma of parotid gland, 1 tumor was acinic cell carcinoma, 1 tumor was malignant peripheral nerve sheath tumor, 2 tumors were synovial sarcoma, 1 tumor was rhabdomyosarcoma, 1 tumor was mucinous adenocarcinoma, 1 tumor was low differentiated adenocarcinoma, 1 tumor was hemangiopericytoma. All patients had plain MRI scan, 32 patients hadconventional enhanced MRI scan, and to compare imaging characteristics of MRI with the pathologicalresults. Statistical analysis was performed with the chi-square test. Results the overall accuracy of plain MRI scanand conventional enhanced MRI scan respectively 51.5% and 78.1%. Conclusion Plain MRI scan combined with conventional enhanced MRI scan can improve diagnostic and differential diagnostic accuracy of parapharyngeal space neoplasms.
【关键词】咽旁间隙;肿瘤;磁共振成像
【中图分类号】R739.63
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2018.01.012
前言
咽旁间隙位于咽外侧颈深部的潜在的疏松结缔组织间隙,位于咽 肌环、腮腺深部与咀嚼肌之间,呈倒立的锥体形。上抵颅底;下达舌 骨平面;前界为翼下颌韧带、颌下腺上缘;后界为椎前筋膜。由茎突 及茎突诸肌为界分为咽旁前、后间隙。咽旁前间隙较小,咽升动、静 脉行于其中,内侧有咽上缩肌及腭扁桃体。咽旁后间隙较大,内有颈 内动、静脉及第Ⅸ-Ⅻ脑神经及颈深上淋巴结。咽旁间隙肿瘤位置较 深,早期诊断较困难,肿瘤较大时手术比较棘手,我们于2006年6月至 2016年12月,回顾性分析33例经手术病理证实的咽旁间隙肿瘤患者, 结合平扫MRI,多期增强扫描的影像,提高咽旁间隙良恶性肿瘤的影像 诊断与鉴别诊断。
中国CT和MRI杂志
第16卷, 第 1 期
2018年01月
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