鼻息肉的CT诊断价值(附124例分析)

The diagnostic value of CT in nasal polyps

目的 :探讨鼻息肉的CT诊断价值 ,为外科手术提供依据。方法 :回顾性分析 12 4例经手术病理证实的鼻息肉病例。全部病例术前均经仰卧位CT扫描 ,其中横断位 11例 ,冠状位 87例 ,横断 +冠状位 2 6例。平扫 88例 ,平扫 +增强36例。结果 :鼻息肉多位于筛窦 +上中鼻道 ;单发息肉呈圆形、卵圆形 ,多发息肉充满鼻腔呈不规则形 ;平扫呈均匀一致的软组织密度 ,CT值约 2 5～ 5 0HU ,增强后多呈轻至中度强化 ,CT值约 35～ 70HU。阻塞性炎症可为全副鼻窦炎或上颌窦炎 +筛窦炎。分型以息肉型和OMC型居多 ;鼻息肉常伴有中下鼻甲肥大 ,鼻中隔偏曲 ,Haller气房及板障型筛窦等解剖变异。结论 :螺旋CT冠状位扫描能直观地显示鼻道、鼻窦整体解剖影像 ,显示病变范围 ,大小 ,毗邻关系及继发改变 ,指导内窥镜手术。

Objective: To investigate the diagnostic value of CT in nasal polyps and to provide information for endoscopic operation.Methods: 124 cases of nasal polyps confirmed by pathology were retrospectively analyzed.All patients had CT scanning, axial plane in 11,coronal plane in 87,axial and coronal plane in 26,plain scanning in 88,plain scanning and contrast enhancement in 36.Results: The nasal polyps mainly occurred in ethmoidal sinus and superior,middle meatuses .Single polyp was round or oval; multiple polyps were irregular in the shape,and filled nasal cavity.Polyps were uniform density (25～50HU) in plain scanning , slight or moderat enhancement (35～70HU) in contrast enhancement.The obstructive sinusitis mainly took place in whole paranasal sinus, maxillary and ethmoidal sinus. The types of polyps and OMC are at most in the classification of nasal polyps; it often has various anatomical variations such as hyperplasia of middle, inferior conchae, the curved nasal septum, Haller air cells,diploic type of ethmoidal sinus et al.Conclusion: The spiral CT especially coronal CT scanning can clearly demonstrate the whole anatomical imaging of meatuses and paranasal sinus, providing the range, size, adjacent relationand second changes of the lesion, directing the operation.