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目的探讨颞骨鳞状细胞癌的临床表现及影像学特点。方法搜集整理经病理证实的8例颞骨鳞状细胞癌患者完整的临床及影像学资料,回顾性分析其临床表现、CT及MRI特点,其中2例行CT平扫加增强扫描,7例行颞骨高分辨率CT扫描,7例行MRI平扫加增强扫描。结果患者在诊断时的平均年龄58岁(中位数),最常见的临床症状是反复外耳道溢液、流脓;病程数十天至10余年不等。病变累及范围:8例均累及外耳道,累及中耳乳突7例,听小骨受累2例,累及内耳道5例。CT表现为不规则软组织密度影,伴颞骨不同程度骨质吸收破坏;MRI表现为不均匀稍长T_1、T_2信号影,增强扫描明显不均匀强化,其中4例均出现不同程度颅内浸润,表现为邻近硬脑膜不同程度增厚强化,2例见脑实质内异常强化影。结论本组颞骨鳞状细胞癌患者以反复外耳道耳流血、流脓为主要临床表现;病变主要发生于外耳道,肿瘤常呈浸润性生长,累及范围较广泛,中耳乳突、内耳常不同程度受累。MRI和CT对颞骨鳞状细胞癌的诊断及病变对周围组织侵犯的评估有重要意义。
Objective To investigate the clinical manifestations and imaging features of temporal bone squamous cell carcinoma. Methods The complete clinical and imaging data of 8 patients with squamous cell carcinoma of the temporal bone confirmed by pathology were collected. The clinical features, CT and MRI features were retrospectively analyzed. Among them, 2 patients underwent CT scan and contrast-enhanced MRI, and 7 patients underwent temporal scan High-resolution CT scan, 7 cases of MRI scan and enhanced scan. Results The average age of patients at diagnosis was 58 years (median). The most common clinical symptoms were repeated external auditory canal discharge and purging. The course of disease ranged from 10 days to more than 10 years. Incidence of lesions range: 8 cases were involved in the external auditory meatus, involving the middle ear mastoid process in 7 cases, 2 cases of ossicular involvement, including 5 cases of internal auditory canal. CT showed irregular soft tissue density, accompanied by varying degrees of temporal bone loss of bone absorption; MRI showed a slightly longer T_1, T_2 signal shadow enhanced scan significantly uneven enhancement, of which 4 cases were different degrees of intracranial infiltration, the performance of Adjacent to the dura mater to varying degrees of thickening enhancement, 2 cases of intraparenchymal enhancement within the shadow. Conclusions This group of patients with temporal bone squamous cell carcinoma has the main clinical manifestations of repeated bleeding in the ear canal and purulent pus. The lesions mainly occur in the external auditory canal. The tumors often show invasive growth with a wide range of involvement. The medial ear mastoid process and the inner ear are often affected to varying degrees . MRI and CT of temporal bone squamous cell carcinoma of the diagnosis and lesions of the surrounding tissue invasion is of great significance.