增强CT在口腔颌面颈部多间隙感染中的应用评价

Application of enhanced computed tomography in oral and maxillofacial and cervical multi-space infection

目的:总结口腔颌面颈部多间隙感染在增强CT上的影像学特点,并评估其对诊断和治疗的应用价值。方法:收集2005年12月-2011年12月口腔颌面颈部多间隙感染并行增强CT检查的连续病例227例,对其发病原因、CT表现、累及间隙、治疗结果、随访CT表现进行回顾分析。结果:病因多为牙源性和腺源性,分别有167例和33例;CT主要表现为脓肿、气体积聚和蜂窝织炎;下颌下间隙累及频率最高,为145例,其次为咬肌间隙(73例)、翼颌间隙(50例)和舌下间隙(48例);出现呼吸道梗阻15例,下行性纵隔炎11例;214例患者治愈,8例失访,5例死亡。结论:增强CT应作为口腔颌面颈部多间隙感染首选的影像学检查,可为术前诊断、指导治疗及判断预后提供有效信息。

PURPOSE： To summarize the imaging features of enhanced computed tomography of oral and maxillofacial and cervical multi-space infection, and to evaluate the effect of enhanced CT for diagnosis and treatment. METHODS： Two hundred and twenty-seven consecutive cases of oral and maxillofacial and cervical muhi-space infection were collected from December 2005 to December 2011, the resource of infection, CT findings, involved space, treatment outcomes and follow-up CT findings were retrospectively analyzed. RESULTS： Odontogenic and gland-borne infection was most frequent, with 167 cases and 33 cases respectively. Infection on enhanced CT showed abscess, gas bubble and cellulitis. Submandibular space was involved most frequently in 145 cases, followed by masticator space in 73 cases, pterygomandibular space in 50 cases and sublingual space in 48 cases; respiratory obstruction was found in 15 cases and descending mediastinitis was found in 11 cases; 214 cases were cured, 8 were lost to follow-up and 5 cases died. CONCLUSION： Enhanced CT should be used as preferred radiographic method of oral and maxillofacial and cervical muhi-space infection. It is effective in diagnosis, guiding therapy and evaluating prognosis. Supported by Research Fund of Science and Technology Commission of Shanghai Municipality （08DZ2271100） and Research Fund of Health Bureau of Shanghai Municipality （2012Y046）.