目的探讨颞骨胚胎型横纹肌肉瘤（RMS）的影像表现,提高其诊断的准确性。方法回顾性分析经病理证实的6例颞骨胚胎型RMS影像资料。结果 6例患者中,男5例,女1例,年龄2-9岁,平均5.5岁,临床表现主要有听力下降,耳部流脓,口角歪斜,面部麻木等。6例患者中,5例行CT平扫和MR平扫加增强检查,另1例仅行CT平扫检查。CT表现主要有颞骨溶骨性骨质破坏,鼓室及乳突部均见软组织肿物,部分病灶累及听小骨、耳蜗、骨半规管及颅底骨质结构。MR表现为颞骨、中耳及乳突区见稍长T1、不均匀稍长T2信号,部分病灶累及外耳道、鼻咽、口咽、翼腭窝等,DWI呈不均匀高信号,增强后病灶呈明显均匀或不均匀强化。结论对于颞骨RMS CT能较好地显示骨质破坏征象,MR能较清楚显示病变侵犯周围组织结构,两者结合可以更准确地提高诊断正确率,但确诊还依赖病理学诊断。
Objective To investigate imaging manifestations of temporal bone embryonal rhabdomyosarcoma in children in order to improve the diagnostic accuracy. Methods The clinical data and imaging materials of 6 child patients with pathologically-proved embryonal rhabdomyosarcoma of temporal bone were retrospectively analyzed. Results The child patients included 5 males and one female,2- 9 years old with a mean of 5. 5 years. Clinically,the main symptoms included hearing loss,ear discharge,ptosis of labial angle,facial numbness,etc. Of the 6 patients,both plain CT and MRI scanning was performed in 5 and only plain CT scanning was employed in one. The main CT findings included osteolytic destruction of the temporal bone,soft tissue mass in the tympanic cavity and mastoid; and auditory ossicles,cochlea,bony semicircular canal and the bone structure of the skull base were involved in some cases. On MRI,the temporal bone,middle ear and mastoid area displayed inhomogeneous slightly long T1 long T2signals,with the external auditory canal,nasopharynx,oropharynx and wing palatine fossa being involved in some cases. On DWI,the lesion was characterized by inhomogeneous higher signal and obvious homogeneous or inhomogeneous enhancement after injection of contrast. Conclusion CT scanning can well display the signs of bone destruction in temporal bone embryonal rhabdomyosarcoma,while MRI can clearly demonstrate the involvement of the neighboring structures. Combination use of CT and MRI can improve the diagnosis accuracy although the confirmation of the diagnosis relies on the pathological examination.
Journal of Clinical Radiology
Temporal bone Rhabdomyosarcoma Tomography X-ray computed Magnetic resonance imaging