上颌窦病变引起骨质改变的CT研究

Study of bone changes due to maxillary sinus disorders with CT

目的探讨CT提示的各种骨质改变对上颌窦良恶性病变的鉴别诊断价值。方法回顾性分析经病理证实的上颌窦良恶性病变101例的CT表现,观察、统计各种骨质改变的部位、范围和类型。结果良恶性病变引起骨质破坏出现率分别为57.5%(23/40)和85.2%(52/61),73.9%(17/23)的良性病变引起的骨质破坏呈单发,而恶性病变引起的骨质破坏以多发为主(78.8%,41/52),两组比较均有显著性差异(P<0.01)。骨膨胀改建的发生率良性组40.0%(16/40),恶性组13.1%(8/61)(P<0.01)。骨质硬化良性组37.5%(15/40),恶性组14.8(9/61)(P<0.01)。突破窦壁外侵的发生率良性组5.0%(2/40),恶性组36.1%(22/61)(P<0.01)。上颌窦内侧壁和鼻甲骨质破坏的发生率良恶性组无显著性差异(P>0.05)。其它骨壁的骨质破坏恶性组均多于良性组。结论分析CT所示骨质改变的不同部位、范围和类型,在上颌窦良恶性病变的鉴别诊断中具有重要的价值。

Objective To probe role of CT in suggesting benign or malignant lesions of the maxillary sinuses by detecting bone changes. Methods A review of CT manifestations of 101 patients with benign or malignant lesions in maxillary sinus was conducted. The lesions were confirmed with pathological means. Location, size and type of bone changes were analyzed and rounded up. Results Bone destruction was found in 57.5%(23/40) of benign lesions and 85.2%(52/61) in malignant lesions (P < 0.01).73.9(%17/23)of bone destruction of benign lesions was single, whereas 78.8(%41/52) of malignant lesions showed extensive involvement, varying significantly( P < 0.01). In benign and malignant lesions,incidence of bone expansion and reconstruction was 40.0(%16/40)and 13.1(%8/ 61), respectively(P <0.01); of osteosclerosis was 37.5(%15/40) and 14. (89/61), respectively (P <0.01); of breakout of sinus wall was 5.0%(2/ 40) and 36.1%(22/61) respectively (P <0.01). Both benign and malignant lesions had the similar frequency of bone destruction in the medial wall of maxillary sinuses and turbinate s(P >0.05), but in the other walls,the bone destruction frequencies of malignant lesions were higher than that of benign lesions. Conclusion It is important to analyze location, size and type of bone changes in differing benign and malignant maxillary sinuses disease.