鼻腔及副鼻窦病变骨质改变的CT研究

Bony changes of the nasal cavity and paranasal sinuses disease:CT study

目的 探讨CT所见骨质改变对鼻腔和副鼻窦良、恶性病变的鉴别诊断价值。材料与方法 经病理证实的鼻腔及副鼻窦良、恶性病变 131例 ,在CT图像上盲法观察各种骨质改变的类型、范围和部位。结果 良、恶性病变有骨质破坏者分别占 6 5 .2 %和 84.7% ;6 6 .7% ,恶性病变的骨质破坏呈多发性 ,良性组以单发为主 (73 .3 % ) ;良、恶性病变突破窦壁的发生率分别是 2 1.7%和 5 2 .9% ;上颌窦内侧壁、筛窦间隔和鼻甲骨质破坏的发生率良、恶性组相似 ,其他骨壁骨质破坏恶性组多于良性组。骨膨胀的发生率两组相近 ,而良性组的骨质硬化多于恶性组 ,神经孔、裂扩大恶性组多于良性组。结论 根据骨质破坏的不同类型、部位和范围 ,CT对鼻腔和副鼻窦良、恶性病变的鉴别诊断可提供较大的帮助。

Purpose [WT5”BZ]To evaluate the value of the bony changes for differential diagnosis of benign and malignant lesions of the paranasal sinuses and nasal cavity based on CT.[WT5”HZ]Materials and methods[WT5”BZ] 131 patients with paranasal sinuses and nasal cavity diseases confirmed by pathology were analyzed,the bony change types,location and extension of lesions were blind investigated on CT scan.[WT5”HZ]Results[WT5”BZ] Bony destruction was found in 84.7% of malignant lesions and was significantly higher than that of benign lesions(65.2%),66.7% of bony destruction of malignant lesions were extensive and multiple involovement,whereas most of benign lesions(73.3%)showed focal and single bony destruction.The mass spread beyond the sinus walls of benign and malignant lesions were 21.7% and 52.9% respectively.Both benign and malignant lesions had the similar frequency of bony destruction in the medial wall of maxillary sinus,ethmoid septum and turbinate bone,but the bony destruction frequencies of malignant lesions were higher than that of benign lesions in the other bony walls.Both benign and malignant lesions had the similar bone expansion incidences,the bony sclerosis of benign lesions were more than that of malignant lesions,whereas neural foramen and fissure enlargements of malignant lesions were significantly more than that of benign lesion.[WT5”HZ]Conclusion [WT5”BZ]Depended on the different bony change types,locations and extensions of the lesions,CT could provide important information for differential diagnosis of benign and malignant paranasal sinuses and nasal cavity diseases.[WT5”HZ]