鼻腔鼻窦骨化纤维瘤的螺旋CT诊断

Spiral CT scanning for the diagnosis of ossifying fibroma in nose and paranasal sinuses

目的探讨螺旋CT在鼻腔鼻窦骨化纤维瘤的诊断价值。方法回顾性研究本院行手术治疗并经病理确诊的鼻腔鼻窦骨化纤维瘤患者24例,分析其临床资料及螺旋CT影像学特征,探讨螺旋CT诊断程序。结果侵犯单个鼻窦的肿瘤12例,包括筛窦8例,上颌窦4例;其中6例伴有鼻腔侵犯。病变同时侵犯多个鼻窦和鼻腔者12例,包括上颌窦和筛窦8例,筛窦和额窦4例。肿瘤的CT表现为鼻腔/鼻窦内单发类圆形或不规则形高密度肿块,部分区域可见低密度影,其周边显示完整的骨性包壳,呈膨胀性生长,周围组织受压变形但界限清晰。结论螺旋CT扫描是诊断鼻腔鼻炎骨化纤维瘤最常用和最有价值的影像学检查手段。

Objective To explore the clinical value of spiral CT scanning for the diagnosis of ossifying fibroma in nose and paranasal sinuses based on a clinical trial. Methods A retrospective study was carried out among 24 cases with ossifying fibroma in nose and paranasal sinuses, diagnosed in our Hospital on the basis of surgery and histopathology from Jul., 2000 to May, 2008. Their clinical data were carefully analyzed, with specially focused attention on their spiral CT image features to explore the feasible diagnostic program for such a lesion. Results Out of this group of patients, 12 were seen with the lesion invading into a single sinus, including 8 in ethmoidal and 4 in maxillary sinus, of them 6 cases with their lesion developed into nasal cavity. And another 12 cases showed their lesion invaded both of multiple paranasal sinuses and nasal cavity at the same time already, including 8 in ethmoidal and maxillary sinuses and 4 in ethmoidal and frontal sinuses. The CT image features of ossifying fibroma in nose and paranasal sinuses were shown as single round-like or un-regular high density of mass, with part of the tumor area showing lower density of image. Furthermore, there may be an integrity bony shell around the mass, with a developing tendency of expansive outwards growth leading to file perienchyma disfigurated by mass press but still showing clear demarcation between them. Conclusion Spiral CT can be taken as a valuable tool in the diagnosis of ossifying fibroma in nose and paranasal sinuses.