慢性中耳乳突炎的HRCT诊断价值

Role of HRCT in diagnosis of chronic otitis media with mastoiditis

目的探讨慢性中耳乳突炎的HRCT特征及诊断。方法回顾性分析76例慢性中耳乳突炎患者的临床和HRCT检查资料,并与手术病理结果对照。结果HRCT能清楚显示外耳、中耳及内耳结构。术前诊断单纯型36耳,胆脂瘤型30耳,肉芽肿型10耳。40耳诊断为胆脂瘤型和肉芽肿型患者均行手术治疗,术前诊断为胆脂瘤型30耳,术后5耳病理证实为肉芽肿型。10耳肉芽肿型术后证实有3耳为胆脂瘤型。结论由于HRCT能清晰显示颞骨结构,对慢性中耳乳突炎性病变发现及定位较准确,对胆脂瘤型和肉芽肿型的鉴别诊断仍有一定困难。

Objective To explore the characteristics and diagnosis of chronic otitismedia with mastoiditis on high resolution computed tomography (HRCT). MethodsClinical data and HRCT findings collected from 76 patients with chronic otitis mediawith mastoiditis were retrospectively studied in comparison with surgical pathological exams.Results External, middle and internal auditory structures were clearly demonstrated onHRCT. 36 ears were diagnosed as simplex type, 30 as choleseatomatus type and 10 asgranulomatus type before operation. 40 ears that were diagnosed as choleseatomas orgranulomas underwent operation. 5 out of 30 ears that were diagnosed as choleseatomatustype preoperatively were proved to be granulomatus type pathologically after theoperation. 3 out of 10 ears diagnosed as granulomatus type preoperatively were provedto be choleseatomatus type pathologically. Conclusion HRCT is able to clearlydemonstrate structure of temporal bone, helping to find out chronic otitis media withmastoiditis and position the lesions. However, it is still difficult to make differentialdiagnosis between choleseatomatus and granulomatus types with HRCT.[