鼻腔原发性恶性黑色素瘤的影像学表现及鉴别诊断

摘要

目的:探讨鼻腔原发性恶性黑色素瘤的影像学表现及鉴别诊断.方法:回顾性分析经病理证实的9例鼻腔原发性恶性黑色素瘤的影像学表现.结果:9例患者主要CT表现为单侧(8例)或双侧(1例)鼻腔内密度均匀、形态不规则的软组织肿块,无钙化,8例(8/9)伴邻近结构的侵犯,2例增强后肿瘤不均匀明显强化,MRI表现:1例表现为典型的T1WI上不均匀高信号,T2 WI上不均匀低信号；2例表现为T1WI上呈等信号或稍高信号,T2WI上稍高信号；3例MRI增强后肿瘤不均匀明显强化.结论:鼻腔原发性恶性黑色素瘤CT表现缺乏特异性,典型的恶性黑色素瘤的MRI表现有一定特征性.CT和MRI能很好地显示肿瘤的部位、周围骨质破坏和邻近重要结构的侵犯.%Objective: To investigate the imaging findings and differential diagnosis of primary malignant melanoma of nasal cavity. Methods:The imaging findings of 9 cases with primary malignant melanoma of nasal cavity proved by pathology were analyzed. Results-Axial unenhanced CT scan showed soft-tissue masses in 9 cases. The tumor displayed a homogeneous density (8 cases in unilateral nasal cavity and 1 case in bilaterial cavity) and irregular configuration without calcification on CT. There were 8 cases with invasion of adjoining structures and 2 cases with inhomogeneous apparent enhancement. MRI showed typical in homogeneous high signal intensities on T1 WI and inhomogeneous low signal intensities on T2WI in 1 case; and isointensity and slightly high signal intensities on T, Wl and slightly high signal intensities on T2WI in 2 cases. There were 3 cases showing inhomogeneous apparent enhancement on both CT and MRI. Conclusion: Our results had shown that the primary malignant melanoma of nasal cavity had no specific CT manifestation. CT and MRI could well define the location of tumor?invasion of bone and the adjoining structures. MRI could be helpful for the diagnosis of typical primary malignant melanoma of nasal cavity.