中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2014年
3期
198-200
,共3页
程玉书%沙炎%洪汝建%黄文虎%韩朝
程玉書%沙炎%洪汝建%黃文虎%韓朝
정옥서%사염%홍여건%황문호%한조
搏动性耳鸣%鼓室球瘤%磁共振成像
搏動性耳鳴%鼓室毬瘤%磁共振成像
박동성이명%고실구류%자공진성상
Pulsatile tinnitus%Glomus tympanicum tumor%Magnetic resonances imaging
目的 提高对合并中耳乳突炎的鼓室球瘤的影像学认识,减少本病的误诊和漏诊.方法 收集复旦大学附属眼耳鼻喉科医院白2002-2011年来临床表现为搏动性耳鸣和听力下降,经手术病理明确诊断为鼓室球瘤且合并中耳乳突炎病例共8例,回顾性分析这些病例的临床与影像学资料,分析其影像学特征以及CT与MRI对其诊断价值.结果 CT术前诊断中,5例诊断为中耳乳突炎,鼓室球瘤被漏诊,另外3例考虑中耳乳突炎伴鼓室球瘤不除外;MR术前诊断6例均考虑为鼓室球瘤合并中耳乳突炎.影像学表现包括,HRCT平扫示8例患侧中耳乳突透亮度均减低,鼓室腔被软组织病变大部分或完全占据,2例病变累及外耳道深部;5例行增强CT扫描,鼓岬旁可见少量强化软组织影,病灶体积较MRI所见偏小;6例MR扫描,T1WI示鼓室见中等信号病变,乳突区见中等或高信号病变;T2WI示鼓室内肿瘤病变呈中高信号,中耳乳突内渗出性病变呈明显高信号;增强后,肿瘤病灶显著强化,中耳乳突内渗出性病变无强化.CT及MRI共发现6例病变累及咽鼓管口.结论 CT对合并中耳乳突炎的鼓室球瘤容易造成漏诊或误诊,对中耳炎患者伴有搏动性耳鸣症状时应引起重视.增强MRI更有利于合并中耳乳头炎的鼓室球瘤的术前诊断及评估.
目的 提高對閤併中耳乳突炎的鼓室毬瘤的影像學認識,減少本病的誤診和漏診.方法 收集複旦大學附屬眼耳鼻喉科醫院白2002-2011年來臨床錶現為搏動性耳鳴和聽力下降,經手術病理明確診斷為鼓室毬瘤且閤併中耳乳突炎病例共8例,迴顧性分析這些病例的臨床與影像學資料,分析其影像學特徵以及CT與MRI對其診斷價值.結果 CT術前診斷中,5例診斷為中耳乳突炎,鼓室毬瘤被漏診,另外3例攷慮中耳乳突炎伴鼓室毬瘤不除外;MR術前診斷6例均攷慮為鼓室毬瘤閤併中耳乳突炎.影像學錶現包括,HRCT平掃示8例患側中耳乳突透亮度均減低,鼓室腔被軟組織病變大部分或完全佔據,2例病變纍及外耳道深部;5例行增彊CT掃描,鼓岬徬可見少量彊化軟組織影,病竈體積較MRI所見偏小;6例MR掃描,T1WI示鼓室見中等信號病變,乳突區見中等或高信號病變;T2WI示鼓室內腫瘤病變呈中高信號,中耳乳突內滲齣性病變呈明顯高信號;增彊後,腫瘤病竈顯著彊化,中耳乳突內滲齣性病變無彊化.CT及MRI共髮現6例病變纍及嚥鼓管口.結論 CT對閤併中耳乳突炎的鼓室毬瘤容易造成漏診或誤診,對中耳炎患者伴有搏動性耳鳴癥狀時應引起重視.增彊MRI更有利于閤併中耳乳頭炎的鼓室毬瘤的術前診斷及評估.
목적 제고대합병중이유돌염적고실구류적영상학인식,감소본병적오진화루진.방법 수집복단대학부속안이비후과의원백2002-2011년래림상표현위박동성이명화은력하강,경수술병리명학진단위고실구류차합병중이유돌염병례공8례,회고성분석저사병례적림상여영상학자료,분석기영상학특정이급CT여MRI대기진단개치.결과 CT술전진단중,5례진단위중이유돌염,고실구류피루진,령외3례고필중이유돌염반고실구류불제외;MR술전진단6례균고필위고실구류합병중이유돌염.영상학표현포괄,HRCT평소시8례환측중이유돌투량도균감저,고실강피연조직병변대부분혹완전점거,2례병변루급외이도심부;5례행증강CT소묘,고갑방가견소량강화연조직영,병조체적교MRI소견편소;6례MR소묘,T1WI시고실견중등신호병변,유돌구견중등혹고신호병변;T2WI시고실내종류병변정중고신호,중이유돌내삼출성병변정명현고신호;증강후,종류병조현저강화,중이유돌내삼출성병변무강화.CT급MRI공발현6례병변루급인고관구.결론 CT대합병중이유돌염적고실구류용역조성루진혹오진,대중이염환자반유박동성이명증상시응인기중시.증강MRI경유리우합병중이유두염적고실구류적술전진단급평고.
Objective To analyze the CT and MRI features of glomus tympanicum tumors accompanied with tympanitis and evaluate the diagnostic value of CT and MRI in order to improve the cognition for the disease.Methods The clinical materials and images of 8 patients with the symptoms of pulsatile tinnitus and hearing loss in whom glomus tympanicum tumors with tympanitis surgically and pathologically confirmed were retrospectively reviewed.The characteristics and diagnostic value of CT and MR imaging were summarized.Results By CT examination the lesions in middle ear and mastoid were preoperatively diagnosed as tympanitis in five cases and only in three cases the glomus tympanicum tumors were suspected.In six patients underwent MR examination the lesions were all preoperatively diagnosed as glomus tympanicum tumors accompanied with tympanitis.HRCT scanning of the temporal bone in all patients showed the soft tissue lesions in the tympanic cavity and mastoid,and the cavitas tympanica were mostly (n =3) or completely (n =5) occupied by soft tissue lesions,but the auditory ossicles were all without destruction.Contrast-enhanced axial CT scanning performed in five cases showed less soft tissue mass on the cochlear promontory,and the size of mass was less than that observed in MR imaging.MR T1-weighted imaging showed the presence of isointense lesions in middle ear and isointense (n =3) or hyperintense (n =3) lesions in mastoid.On T2-weighted imaging the lesions with slight hyperintense were viewed in the middle ear and the lesions with hyperintense in mastoid.T1-weighted gadolinium-enhanced MRI showed the masses in tympanum were markedly increased enhancement,but the lesions in mastoid without enhancement.MRI and CT imaging revealed the masses in six cases of eight extending to the eustachian tube.Conclusion When the glomus tympanicum tumor was accompanied with tympanitis the tumor could be misdiagnosed or missed only by CT examination.The patients with pulsatile tinnitus should be taken seriously.MRI with contrast-enhancement is superior to CT in the preoperative diagnosis and accurately evaluation for the glomus tympanicum tumors with tympanitis.
