CT诊断上颌窦疾病的研究

CT Diagnosis of Maxillary Sinus Diseases

笔者回顾分析了ＣＴ诊断的５３例上颌窦疾病，经手术病理证实。ＣＴ扫描提示上颌窦炎性病变２３例，息肉样病变７例，囊性病变９例，良性肿瘤４例，恶性肿瘤９例，骨纤维异常增殖症１例。与病理诊断对比基本符合，仅１例（２％）为假阳性。在诊断上颌窦疾病方面，ＣＴ可以解决一些传统难题，如提高对窦壁周围组织估计的正确性，可证实肿瘤对翼部、咽部及鼻腔的侵犯，有助于手术方案的制定。由于ＣＴ密度分辨率高，超越了平片及多轨迹体层，得以确定软组织、骨壁及含气腔的隐匿性变化，加上增强扫描可推测病变为血管性或非血管性。对于鉴别囊肿、脓肿、良恶性肿瘤等均起到重要作用。

The results of CT scanning in 53 patients with maxillary sinus diseases confimed by operation and pathology were analysed retrospectively.The diagnosis suggested on CT scan included in-flammatory lesion 23 cases, polyp7,cyst9,benigh tumors4,malignant tumor 9 and fibrous dysplasia of bone one case. Basically,the CT diagnosis was in accordance with pathologic findings with the excep-tion of 1 false positive case. The study showed that CT examination was useful in resolving some diffi-cult clinical problems,such as estimating the changes of soft tissue adjacent to sinus wall,defining tu-mor involvement of pterion,pharynx and nasal cavity,thereby helpful to operative procedure planning.CT scan,by virtue of its high contrast resolution,is superior to conventional radiography or tomography in detecting subtle changes of soft tissue,bone and sinus.Enhanced CT scanning is helpful in distinguishing vascular and non-vascular lesions.CT also plays an important role in differentiation between mucocele and pyocele,benign and malignant tumors.