慢性化脓性中耳乳突炎螺旋CT诊断价值

Diagnosis of chronic suppurative otitis media with helical CT

目的探讨慢性化脓性中耳乳突炎螺旋CT检查的诊断价值。方法对手术及病理证实的48例65耳慢性化脓性中耳乳突炎患者术前进行螺旋CT扫描并与手术及病理结果对照分析。结果48例中,胆脂瘤型32耳,典型者表现为上鼓室、鼓窭及其入口内团块样或弥漫性软组织病灶,边缘见低密度环,骨缘硬化,鼓室扩大,盾板变钝或破坏,听小骨明显破坏;肉芽肿型28耳,主要表现为鼓室及鼓窦内软组织条索及片网影,听小骨破坏较轻;单纯型15耳,表现为中耳腔内黏膜增厚、积液。三维CT听骨链显示情况与手术一致。结论螺旋CT扫描对慢性化脓性中耳乳突炎术前诊断及分型有重要意义,三维CT成像对制定手术方案,提高手术安全性有很大价值。

Objective To explore the value of helical CT in diagnosis of chronic suppurative otitis media. Methods The helical CT findings of 48 cases （65 ears） proved by operation and pathology were studied. Results The typical appearances of 32 ears in 48 cases as cholesteatomatous type were a large soft-tissue mass in the epitympanic cavity, sinus tympani and aditus, ring of low density, enlargement of the antrumtympanicum and its aditus, thicken or destruction of the tympanic tegmen, obvious destruction of ossicles appeared in most of them. 28 granulomas with the typical appearances of patch-like, streak-like or soft-tissue mass in the tympani, mild destruction of the bone in most of them. The typical appearance of the 15 ears with simple type were mucous membrane thickened, middle ear effusion. Three-dimentional image were in accord with those seen in the operation. Conclusion Helical CT scan is of great value in the diagnosis and classify of chronic suppurative otitis media preoperatively. Three-dimentional image can provide valuable information for surgery and increase the safety therefore.