慢性化脓性中耳炎螺旋CT诊断

Helical CT diagnosis in chronic suppurative otitis media

本文对经手术病理证实的慢性化脓性中耳炎37例42耳,其中单纯型7耳,骨疡型(肉芽肿型)12耳,胆脂瘤型23耳CT、平片所见与手术、病理对照。发现单纯型7耳和骨疡型12耳乳突平片均为乳突密度增高,23耳胆脂瘤型中乳突平片10耳见明确的骨质破坏,诊断为胆脂瘤型,5耳见鼓窦入口略大可疑胆脂瘤形成,8耳胆脂瘤漏诊。螺旋CT清楚地显示了耳内外解剖结构,且显示的病变及其范围和浸润的程度均与手术所见一致,此外,还发现3例合并脑脓肿。作者认为乳突平片已不能适应现代耳科显微手术的发展,不能满足临床的需要,螺旋CT明显优于平片,对慢性化脓性中耳炎术前诊断具有重要意义。

Purpose: To evaluate the value of spiral CT in chronic suppurative otitis media. Method: The images of spiral CT and plain films of 37 cases with chronic suppurative otitis media were compared with surgical findings. Results: 8 ears of cholesteatomas were missing and there were the same findings which the mastoid density is high in simple type and in granunoma type in plain films. Spiral CT showed not only anatomical detail in all ears but also soft tissue mass and erosion of bone clearly in 23 ears of cholesteatoma type and in 12 cars of granunomas type. Conclusion: Spiral CT is more superior over traditional X-rays in chronic suppurative otitis media. Spiral CT is of important role in chronic suppurative otitis media in preoperative diagnosis.