咽旁间隙原发肿瘤的MRI特点分析
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摘要
目的分析咽旁间隙原发肿瘤的MRI表现特点,提高对该区域病变鉴别诊断的认识。方法回顾性分析42例经手术病理证实的咽旁间隙肿瘤的MRI表现及临床资料。结果 42例中,良性肿瘤27例,包括15例神经源性肿瘤(11例神经鞘瘤,4例副神经节瘤),6例多形性腺瘤,3例纤维血管瘤,1例海绵状血管瘤,1例鳃裂囊肿,1例血管平滑肌脂肪瘤;恶性肿瘤15例,包括1例恶性神经鞘瘤,6例恶性间叶组织肿瘤(3例软骨肉瘤,1例肌纤维母细胞瘤,2例平滑肌肉瘤),3例腺样囊性癌,1例淋巴瘤,1例鳞状细胞癌,1例浸润性腺癌,1例肌上皮癌,1例粘液表皮样癌。咽旁间隙肿瘤分为神经源性、涎腺来源、间叶组织来源及其它组织来源;良性肿瘤边缘多光滑,与周围分界清楚;恶性肿瘤信号多不均匀,边界不规则,向周围浸润生长。多数肿瘤有其各自的MRI表现特点。结论咽旁间隙肿瘤病理种类多样,了解此间隙肿瘤的MRI特点,有助于提高诊断准确率。
Objective To investigate the MRI features and differential diagnosis of primary tumors in parapharyngeal space.Methods MRI findings,clinical data were analyzed retrospectively in 42 cases with tumors in parapharyngeal space confirmed by surgical pathology. Results Among 42 cases,there are 27 cases of benign tumors,including 15 cases of neurogenic tumor(schwannoma,11 cases,paraganglioma,4 cases),6 cases of pleomorphic adenoma,3 cases of angiofibroma,1 case of cavernous hemangioma,1 case of cleft cyst and angiomyolipomas; and 15 cases were malignant tumors,including 1 case of malignant schwannoma,6 cases of malignant mesenchymal tissue tumors( chondrosarcoma,3 cases,myofibroblastic tumor,1 case,leiomyosarcoma,2 cases),3 cases of adenoid cystic carcinoma,1 case of lymphoma,1 case of squamous cell carcinoma,1 case of infiltrating adenocarcinoma,1 case of myoepithelial carcinoma and mucous epidermoid carcinoma. The primary tumors in parapharyngeal space are derived from neurogenic tumor,salivary gland,mesenchymal tissue and other tissues. A clear boundary and smooth edge exist in the benign tumors,where as,more uneven signal,irregular boundary and infiltrating growth exist in the malignant tumors. Most of the tumors have their own MRI characteristics. Conclusion There are various types of parapharyngeal space tumors in pathology,so understanding certain MRI characteristics can help to improve the diagnostic accuracy.
Objective To investigate the MRI features and differential diagnosis of primary tumors in parapharyngeal space.Methods MRI findings,clinical data were analyzed retrospectively in 42 cases with tumors in parapharyngeal space confirmed by surgical pathology. Results Among 42 cases,there are 27 cases of benign tumors,including 15 cases of neurogenic tumor(schwannoma,11 cases,paraganglioma,4 cases),6 cases of pleomorphic adenoma,3 cases of angiofibroma,1 case of cavernous hemangioma,1 case of cleft cyst and angiomyolipomas; and 15 cases were malignant tumors,including 1 case of malignant schwannoma,6 cases of malignant mesenchymal tissue tumors( chondrosarcoma,3 cases,myofibroblastic tumor,1 case,leiomyosarcoma,2 cases),3 cases of adenoid cystic carcinoma,1 case of lymphoma,1 case of squamous cell carcinoma,1 case of infiltrating adenocarcinoma,1 case of myoepithelial carcinoma and mucous epidermoid carcinoma. The primary tumors in parapharyngeal space are derived from neurogenic tumor,salivary gland,mesenchymal tissue and other tissues. A clear boundary and smooth edge exist in the benign tumors,where as,more uneven signal,irregular boundary and infiltrating growth exist in the malignant tumors. Most of the tumors have their own MRI characteristics. Conclusion There are various types of parapharyngeal space tumors in pathology,so understanding certain MRI characteristics can help to improve the diagnostic accuracy.
引文
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[11]曾莎莎,郭建东,张水兴.CT与MRI在颅底软骨肉瘤诊断中的应用价值[J].医学影像学杂志,2014,24(2):183-186.
[12]刘霞,于台飞,高建伟,等.颅底肿瘤的MRI诊断[J].医学影像学杂志,2013,23(9):1354-1357.
[2]Grilli G,Suarez V,Munoz MG,et al.Parapharyngeal space primary tumours[J].Acta Otorrinolaringol Esp,2017,68(3):138-144.
[3]Singh M,Gupta SC,Singla A.Our experiences with parapharyngeal space tumors and systematic review of the literature[J].Indian J Otolaryngol Head Neck Surg,2009,61(2):112-110.
[4]Kuet ML,Kasbekar AV,Masterson L,et al.Management of tumors arising from the parapharyngeal space:a systematic review of 1,293 cases reported over 25 years[J].Laryngoscope,2015,125(6):1372-1381.
[5]于小平.侵及咽旁间隙的腮腺深叶肿瘤影像表现[J].实用放射学杂志,2015,31(1):28-30.
[6]胡杉,梁长虹,周正根,等.腮腺深叶肿瘤累及咽旁间隙的影像学表现[J].影像诊断与介入放射学,2015,24(4):283-286.
[7]袁文欣,刘立志,崔春燕,等.粘液表皮样癌临床与影像特点的研究[J].中国CT和MRI杂志,2012,10(5):27-30.
[8]Shimamoto H,Chindasombatjaroen J,Kakimoto N,et al.Perineural spread of adenoid cystic carcinoma in the oral and maxillofacial regions:evaluation with contrast-enhanced CT and MRI[J].Dento Maxillo Facial Radiology,2012,41(2):143-151.
[9]皮国良,徐鹏,韩光.肌上皮癌的研究进展[J].中国肿瘤临床,2017,44(6):253-257.
[10]傅敏,王小冰,吴佩娜,等.咽旁间隙肌上皮癌的影像学及临床病理分析[J].临床耳鼻咽喉头颈外科杂志,2007,21(19):879-881.
[11]曾莎莎,郭建东,张水兴.CT与MRI在颅底软骨肉瘤诊断中的应用价值[J].医学影像学杂志,2014,24(2):183-186.
[12]刘霞,于台飞,高建伟,等.颅底肿瘤的MRI诊断[J].医学影像学杂志,2013,23(9):1354-1357.