扁桃体结石的患病率及CT诊断

Prevalence of tonsilloliths and CT diagnosis

目的 总结扁桃体结石的患病率、性别和年龄分布等特点及其CT诊断.方法 回顾2015年11月至2016年11月2 710例行头颈部CT扫描患者的CT图像资料,并分析扁桃体结石的患病率、性别和年龄分布等特点及其CT表现.应用SPSS18.0进行统计学分析.结果 共发现383例扁桃体结石,患病率为14.1%;其中男性217例,患病率为15.1%;女性166例,患病率为13.1%;男女患病率差异无统计学意义.发病年龄为6~88岁,平均（51.1±16.8）岁,其中年龄≤40岁患者与年龄＆gt;40岁患者患病率差异有统计学意义（x2=15.201,P＜0.001）,且患病率与年龄呈正相关（r=0.812,P=0.008）.发生于左侧扁桃体157例,右侧128例,双侧98例,左右侧扁桃体患病率相似,差异无统计学意义（x2=1.919,P=0.166）.以单发小结石多见,单发者约占60.6%,多发者占39.4%;结石的最大径为1.0~10.0 mm,平均（2.3±1.2）mm,最大径≤3.0 mm者占86.7%.扁桃体结石在CT上多表现为扁桃体隐窝或实质内的斑点状、小圆形或卵圆形高密度影,CT值多在120 Hu以上.结论 扁桃体结石临床常见,CT诊断不难,临床及影像医生认识有待提高.

Objective To investigate the prevalence, gender and age distribution characteristics of tonsilloliths and its CT diagnosis, in order to improve the knowledge of clinicians.Methods The images of 2 710 patients who underwent head and neck CT scans from November 2015 to November 2016 were retrospectively reviewed, the prevalence, gender and age distribution of tonsilloliths and CT manifestation were analyzed.SPSS 18.0 was used for statistical analysis.Results Tonsilloliths were found in 383 （14.1%） of the 2 710 patients, including 217 men and 166 women.The prevalence was 15.1% in men and 13.1% in women, and no gender difference was seen.The age of patients with tonsilloliths ranged from 6-88 years, and the mean age was （51.1±16.8） years.The prevalence of tonsilloliths in patients 40 years and younger was significantly lower than in those who were over 40 years （x2=15.201,P〈0.001）, and the prevalence of tonsilloliths was positively correlated with age（r=0.812,P=0.008）.One hundred and twenty eight cases of tonsilloliths were located on the right side, and 157 were located on tleft side.Tonsilloliths were detected bilaterally in 98 patients.There was no significant difference between left and right sides（x2=1.919,P=0.166）.Most of tonsilloliths showed a single small tonsillolith, 60.6% of tonsilloliths showed only one tonsillolith, whereas 39.4% showed two or more.The size of tonsilloliths ranged from 1.0 to 10.0 mm, the mean maximum diameter was （2.3±1.2） mm, and 86.7% of tonsilloliths with a maximum diameter of no more than 3.0 mm.Tonsilloliths showed dot, round or oval hyperdense in tonsillar crypt or parenchyma.CT attenuation of majority tonsilloliths was over 120 Hu.Conclusion Tonsilloliths are more common than previously suggested, its CT diagnosis is not difficult, and the knowledge of clinician and radiologist needs to be improved.