HRCT与鼻内镜对鼻窦炎鼻息肉相关异常诊断的比较

Comparative study of coronal HRCT and nasal endoscopy in abnormalities correlated with chronic sinusitis and nasal polyps

目的对照鼻窦炎鼻息肉的冠状位HRCT表现与FESS术中内镜所见,比较两种方法对鼻腔内间隙、窦口等异常的精确诊断能力。方法详细记录102例(202侧)鼻窦炎鼻息肉冠状位HRCT表现与FESS手术中所见。结果①对鼻腔内间隙和上颌窦口狭窄的检出,CT优于内镜;对前筛口、后筛口和蝶窦口的显示,内镜优于CT。②中鼻道息肉和鼻中隔偏曲的诊断率,内镜高于CT。③上颌窦内异常,如黏稠脓液、黏膜增厚、息肉、黏膜囊肿等,CT表现有一定特点。结论冠状位HRCT和内镜对鼻窦炎鼻息肉相关异常的精确诊断各有优势,应该互相补充、印证,不可以相互替代。

Objective To determine the accuracy of coronal high resolution computed tomography （HRCT） scanning and nasal endoscopy in diagnosis of the coarctation of nasal spaces and ostia, and other abnormalities in patients with chronic sinusitis （CS） and nasal polyps. Methods Making special observation to nasal spaces, ostia and so forth on prsoparative CT films and in the course of functional endoscopic sinus surgery （FESS）, CT manifestations were compared with endoscopic findings in 102 patients （202 sides） undergoing FESS for CS and nasal polyps. Results ① The display rates coarctation of nasal spaces and the maxillary ostium were higher on CT film than on endoscopy while those of the anterior ethmoid, posterior ethmoid, and sphenoid sinus ostia were inverse. ② The diagnostic rates of deviated nasal septum and nasal polyps in the middle meatus were higher on endoscopy than on CT film. ③ The secretory liquid, hypertrophic mucosa, polyps, and mucosal cyst in maxillary sinus had certain characteristics on CT film. Conclusion The coronal HRCT scanning and the nasal endoscopy have respective preponderance in diagnosis of abnormalities correlated with CS and nasal polyps. They can he supplemented and confirmed, but can not he replaced each other in clinical practice.