冠状位高分辨CT对副鼻窦疾病诊断价值.doc

冠状位高分辨CT对副鼻窦疾病诊断价值【摘要】 目的 探讨冠状位高分辨CT对副鼻窦疾病的诊断价值,提高诊断水平。方法 回顾性分析经手术和病理证实的100例患者的副鼻窦CT表现,所有患者均为仰卧、冠状位扫描,层厚、层间距分别为3、6 mm,高分辨骨算法重建。根据CT表现不同分为三个组,即解剖变异组、炎症组和肿瘤组。结果 解剖变异组55例118个部位,所有图像都能清晰显示解剖变异和鼻道窦口复合体等重要结构;炎症组70例,肿瘤组10例均被手术、病理证实。结论 HRCT对副鼻窦病变可以准确诊断,对窦壁和窦外的病变可以完整描述作出,HRCT应作为FESS术前常规检查,对设计手术方式、判断手术疗效和有无复发都具有临床意义。 【关键词】 副鼻窦疾病; CT诊断 The value of coronal high-resolution CT in the evaluation of accessory nasal sinus diseases CHEN Kai,HONG Guo-bin,YIN Fang,et al. Department of Radiology,Affiliated Fifth Hospital,Zhongshan University,Zhuhai 519000,P.R China 【Abstract】 Objective The value of coronal high-resolution CT was assessed in the evaluation of paranasal sinus diseases.Methods A retrospective study of paranasal sinus CT imaging of 100 patients,which were confirmed by surgery and pathology.Bachlying、coronal scanning,3 mm slice thickness,6 mm slice pitch and high-resolution bone algorithm reconstruction for all the patients. We got there groups according to the CT manifest:anatomy variation、inflammation and tumor.Results There were 55 patients and 118 sites in anatomy variation group,all the images can display the important structure of anatomy variation and ostiomeatal complex clearly;70 patients in inflammation group and 10 patients in tumor group,which were all confirmed by surgery and pathology.Conclusion HRCT could accurately diagnose paranasal sinus diseases,and completely describe the lesion of either the sinus wall and out of the sinus.HRCT should be the routine examination before FESS,it has great clinical value for designing surgical plan and evaluating theeffect and recurrence. 【Key words】 Paranasal Sinuses diseases;CT 副鼻窦因其特殊的解剖位置和功能的关系,极易发生各种解剖变异和病变。螺旋CT对副鼻窦疾病的检查和诊断为临床提供了最直观的影像资料,特别是冠状位高分辨CT(HRCT)作为功能性鼻内窥镜(FESS)术前常规检查逐渐被临床所默认。本文总结了经手术病理证实的100例副鼻窦HRCT表现,介绍了副鼻窦解剖变异、炎性病变和各类肿瘤,以期提高副鼻窦病变的CT诊断水平。 1 材料和方法 分析本院2000年1月至2002年12月经CT和FESS手术的100个病例,依据FESS的病理生理基础,本组病例分为解剖变异组、炎症组和肿瘤组。其中解剖变异组55例,炎症组70例,肿瘤组10例。所有病例均经手术病理证实。其中男60例,女40例。年龄7～70岁之间,平均37岁。