Value of MRI in assessing regional invasion and neural spread in sinonasal and nasopharyngeal adenoid cystic carcinoma
10.3969/j.issn.1673-9701.2023.36.020
- VernacularTitle:MRI评价鼻窦鼻腔和鼻咽部腺样囊性癌的区域侵犯和神经扩散的价值
- Author:
Xiangyi LIU
1
;
Xingfa CHEN
;
Meng LIU
;
Qiang XU
Author Information
1. 福建医科大学肿瘤临床医学院 福建省肿瘤医院放射诊断科,福建福州 350014
- Keywords:
Adenoid cystic carcinoma;
Sinonasal tumors;
Nasopharyngeal tumors;
Neural spread;
Magnetic resonance imaging
- From:
China Modern Doctor
2023;61(36):87-90,94
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of MRI in assessing regional invasion and neural spread of sinonasal and nasopharyngeal adenoid cystic carcinoma(ACC).Methods A retrospective collection of MRI and clinical data was analyzed in 22 patients with sinonasal and nasopharyngeal ACC confirmed by pathology.Results A total of 22 patients were included in the study.Invasion of the pterygopalatine fossa was observed in 15 cases,involvement of the masticatory muscles in 13 cases,skull base involvement in 13 cases,infiltration of the cavernous sinus in 9 cases,involvement of the infraorbital fissure in 9 cases,orbital involvement in 5 cases,and intracranial involvement in 6 cases.Only 3 patients presented with cranial nerve symptoms.MRI revealed thickening and enhancement of cranial nerves in 10 cases,with involvement of the maxillary and mandibular(V2,V3)branches of the trigeminal nerve(V)in 9 cases,and muscle denervation caused by nerve damage in 6 cases.Among the 12 patients who underwent surgery,9 cases were confirmed to have neural invasion by pathology,with MRI showing cranial nerve alterations in 7 cases of them,one case showed tumor involvement from the pterygopalatine fossa and medial pterygoid muscle to the cavernous sinus and Meckel cavity,while the other case showed tumor involvement from the pterygopalatine fossa to the sphenopalatine foramen.During the follow-up after treatment,4 of 11 patients experienced recurrence,all of which were accompanied by lung metastasis and pre-treatment neural invasion.Conclusion Sinonasal and nasopharyngeal ACC is characterized by a tendency for neural spread,extensive local invasion,and a high risk of recurrence.MRI is helpful in determining the extent of invasion and neural spread.
