中国耳鼻咽喉头颈外科
中國耳鼻嚥喉頭頸外科
중국이비인후두경외과
CHINESE ARCHIVER OF OTOLARYNGOLOGY-HEAD AND NECK SURGERY
2015年
8期
422-425
,共4页
房高丽%王成硕%张罗
房高麗%王成碩%張囉
방고려%왕성석%장라
乳头状瘤,内翻%体层摄影术,X线计算机%磁共振成像%起源%恶变
乳頭狀瘤,內翻%體層攝影術,X線計算機%磁共振成像%起源%噁變
유두상류,내번%체층섭영술,X선계산궤%자공진성상%기원%악변
Papilloma,Inverted%Tomography,X-Ray Computed%Magnetic Resonance Imaging%originating site%malignant change
目的分析鼻腔鼻窦内翻性乳头状瘤的CT和MRI表现，探讨其诊断价值。方法回顾37例经病理证实的鼻腔鼻窦内翻性乳头状瘤的CT和MRI影像，并与术中所见、术后病理及随访结果比较。结果37例中，起源于上颌窦10例，筛窦8例，额窦6例，鼻甲6例，窦口鼻道复合体3例，蝶窦1例，不能确认起源3例。CT表现：单侧鼻腔鼻窦软组织病变，骨炎征的出现率为62.16%，与起源部位一致的72.00%，3例出现眶纸板或前颅底骨质破坏，与恶变相关。MRI表现：36例出现脑回征，根据脑回征逆向回溯法，32例准确预测起源部位。结论CT与MRI相结合，对于判断鼻腔鼻窦内翻性乳头状瘤的起源、范围及是否合并恶变更具有诊断价值。
目的分析鼻腔鼻竇內翻性乳頭狀瘤的CT和MRI錶現，探討其診斷價值。方法迴顧37例經病理證實的鼻腔鼻竇內翻性乳頭狀瘤的CT和MRI影像，併與術中所見、術後病理及隨訪結果比較。結果37例中，起源于上頜竇10例，篩竇8例，額竇6例，鼻甲6例，竇口鼻道複閤體3例，蝶竇1例，不能確認起源3例。CT錶現：單側鼻腔鼻竇軟組織病變，骨炎徵的齣現率為62.16%，與起源部位一緻的72.00%，3例齣現眶紙闆或前顱底骨質破壞，與噁變相關。MRI錶現：36例齣現腦迴徵，根據腦迴徵逆嚮迴溯法，32例準確預測起源部位。結論CT與MRI相結閤，對于判斷鼻腔鼻竇內翻性乳頭狀瘤的起源、範圍及是否閤併噁變更具有診斷價值。
목적분석비강비두내번성유두상류적CT화MRI표현，탐토기진단개치。방법회고37례경병리증실적비강비두내번성유두상류적CT화MRI영상，병여술중소견、술후병리급수방결과비교。결과37례중，기원우상합두10례，사두8례，액두6례，비갑6례，두구비도복합체3례，접두1례，불능학인기원3례。CT표현：단측비강비두연조직병변，골염정적출현솔위62.16%，여기원부위일치적72.00%，3례출현광지판혹전로저골질파배，여악변상관。MRI표현：36례출현뇌회정，근거뇌회정역향회소법，32례준학예측기원부위。결론CT여MRI상결합，대우판단비강비두내번성유두상류적기원、범위급시부합병악변경구유진단개치。
OBJECTIVE To investigate the CT
<br> and MRI findings of sinonasal inverted papilloma so as to promote the diagnostic accuracy. METHODS All of the 37 cases of sinonasal inverted papilloma (SNIP) were confirmed by pathology. Both MRI and CT scans were performed preoperatively and were analyzed retrospectively for each of the patients. RESULTS The lesion originated from the maxillary sinus in 10 cases, the frontal sinus in 6 cases, the turbinate in 6 cases, ostiomeatalcomples(OMC) in 3 cases, the sphenoid sinus in 1 case, and uncertain or multifocal origins in 3 cases. Previous sinonasal operations were undertaken in 13 patients and 3 cases were associated with malignant change. Analysis of CT images revealed osteitis sign in 23 patients, hyperostosis or osteolysis in 37 patients. Surgical evaluation revealed that the location of osteitis coincided with the actual tumor attachment site (18/25, 72.00%). Bony destruction or extension into the anterior cranial fossa and orbital paperacea in 3 cases was associated with malignant change. Convoluted cerebriform pattern (CCP) in MRI was present in (36/37, 97.30%) patients. For 32 patients, the SNIP originating site predicted by MRI was confirmed by operation (32/36, 88.89%). Focal loss of CCP in 3 cases may be an indicator of coexistent malignancy. CONCLUSION It is the best choice to evaluate the SNIP by combining MRI and CT preoperatively. This may facilitate accurate and complete excision of SNIP and possibly lead to low recurrence.
