鼻腔及副鼻窦良恶性病变的CT鉴别诊断

Differential diagnosis between benign and maglignent lesions of nasal cavity and paranasal sinuses with CT

目的:探讨鼻和副鼻窦良恶性病变的CT特征.方法:本组75例中良性病变58例,恶性病变17例,均作CT轴位扫描,部分病例有冠状位及增强扫描资料,全部病例并经病理学和/或细菌学确认.对各类病变的CT征像进行分析.结果:47例良性病变为液性或混杂密度,12例病变膨胀性生长致上颌窦内侧壁或筛窦、蝶窦骨壁破坏,而44例有骨质增生.7例恶性病变呈软组织密度,浸润生长,骨质破坏,仅1例同时伴有骨质增生.2例肉芽肿表现与恶性病变相似.结论:膨胀性生长、窦壁骨质增生及混杂密度为良性病变表现,而软组织密度,浸润性生长致骨质破坏,尤其是上颌窦前、后及外侧壁的破坏为恶性征像.

Purpose:To discuss the CT features of nasal and paranasal disease. Methods:75 patients included 58 with benign lesion and 17 with malignent tumor,Axial scan was performed in all patients,cornoral and enhancement images were obtained in partial cases. The entity of all lesions was demonstrated by pathology and/or bacteriology. The CT findings of all subgroups were analysed. Results:The benign lesions in 47 cases presented liquid or mixed density ,12 of them had destruction of medical wall of maxillary sinus and wall of ethmoid sinus and sphenoid sinus,44 had hyperplasia of bony wall. 7 malignent lesion had density of soft tissue,bony infiltration and destruction, one of them had hyperplasia,2 inflammatory granuloma had findings similar to ma-lignent tumors. Conclusion:Expensile development,hyperplasia of bone,mixed density are characteristics of benign lesion,infiltra-tive development, and destruction of sinal wall, especially the anterior, posterior and lateral wall of maxillary sinu, is malignent findings.