中鼻道息肉与中鼻甲高度关系的CT研究

The relationship of middle meatus polyps and development of the middle conchas CT study

目的 研究中鼻道息肉与中鼻甲高度的关系 ,以及鼻腔喷布麻黄碱后CT冠状面扫描诊断中鼻道息肉的价值。方法 回顾分析临床疑有鼻窦炎、鼻息肉且手术病理 (40例 )、鼻腔镜 (6 2例 )及CT检查资料完整的 10 2例。CT检查前双侧鼻腔喷布 1%麻黄碱并嘱病人仰卧 ,头呈过伸位5min以上。病人仰卧于检查床上 ,行鼻腔与鼻窦轴面与冠状面CT扫描 ,层厚 2mm ,高分辨率重建 ,分别观察鼻腔黏膜收缩情况与中鼻道软组织肿物 (息肉 )。将中鼻甲与半月裂的关系分为裂上型 (中鼻甲下缘高于半月裂 ) ,裂口型 (中鼻甲下盏与半月裂位于同一水平 ) ,裂下型 (中鼻甲下缘低于半月裂 ) ,测量并统计裂下型中鼻甲彪月裂水平至鼻甲下缘的长度 ,并与中鼻道息肉发生情况对照。结果10 2例中CT扫描鼻腔黏膜收缩满意、尚满意、病变显示清楚者 98例 ;鼻腔黏膜收缩差者 4例。 10 2例中 4 7例 71侧CT诊断为中鼻道息肉 ,并经手术和 (或 )临床证实。 10 2例 2 0 4侧中中鼻甲为裂上型 18侧 ,发生中鼻道息肉 11侧 (6 1 1% ) ;裂口型 38侧 ,发生中鼻道息肉 2 8侧 (73 7% ) ;裂下型 14 8侧 ,发生中鼻道息肉 32侧 (2 1 6 % ) ,明显少于列上型和裂口型者 ,差异具有非常显著性意义 (P值均 <0 0 1)。结论 鼻腔喷布麻黄碱后CT冠状面扫描简单易行 ,可很好?

Objective To study the relationship between polyps of middle meatus and the position of the inferior border of the middle concha related to the semilunar hiatus, and to evaluate the diagnostic value of coronal CT scan of the nasal cavity after ephedrine spray by means of comparison of CT images and clinical findings Methods The coronal CT studys of 102 cases clinically suspected as sinusitis and/or nasal polyps were included in this study 1% ephedrine was sprayed in nasal cavity of the patients before CT study and the patient were asked to take supine position with head over extended over 5 minutes Axial and coronal CT scan was taken with supine position, 2 mm slice thickness and high resolution reconstruction Observation was focused on contraction of the nasal mucosa and soft tissue mass of the middle meatus (polyps) The middle concha was divided into 3 types according the position of its inferior border related to the semilunar hiatus: superior hiatus type (the inferior border of the middle concha superior to the semilunar hiatus), hiatus type (the inferior edge of the middle concha at the level of the semilunar hiatus), inferior hiatus type (the inferior edge of the middle concha inferior to the semilunar hiatus) Statistic comparing the occurrence of the middle meatus polyps with different middle conchas type and measuring the length of the middle conchas of inferior hiatus type from the level of the semilunar hiatus to the inferior border were performad Results Good and better contraction of the nasal mucosa with clear manifestation of the lesion was seen in 98 of 102 cases Nasal polyps of middle meatus were diagnosed in 71 sides of nasal cavities of 47 cases and confirmed surgically and/or clinically 39 superior hiatus and hiatus middle conchas were found ipsilateral to the polyps (54 9%) Of 204 sides of 102 cases, superior hiatus type middle conchas was found in 18 sides of nasal cavity with middle meatus polyps in 11 sides (61 1%); hiatus type in 38 sides with middle meatus polys in 28 sides (73 7%); and inferior hiatus type in 148 sides with middle meatus polys in 32 sides (21 6%) The difference was markedly significant statistically Conclusion Coronal CT scan after ephedrine spray into the nasal cavity can depict the mass in the nasal cavity better, especially nasal polyps with swollen mucosa The method is simple and easy to perform The poorly developed middle concha and the exposed middle meatus may be one of the causes of polyps of middle meatus It clues on that the middle concha should be preserved as much as possible during the endoscopic sinus surgery, opening the ethmoidal infundibulum and bullas, to decrease post operative recurrence of middle meatus polyps