本文關鍵詞：膽脂瘤型中耳炎多層螺旋CT術前評估與術中所見對比研究　出處：《昆明醫(yī)學院》2010年碩士論文　論文類型：學位論文

  更多相關文章： 膽脂瘤 中耳炎 多層螺旋CT 符合率

【摘要】： [目的]通過對膽脂瘤型中耳炎患者多層螺旋CT影像學診斷與術中在耳科手術顯微鏡下所見的對比研究,來評估術前診斷與術中所見的診斷符合率,進而探討多層螺旋CT對膽脂瘤型中耳炎侵襲范圍及骨質(zhì)破壞程度的臨床診斷價值,為選擇手術方式、進路及預后判斷提供參考標準。 [方法]選擇昆明醫(yī)學院第一附屬醫(yī)院耳鼻咽喉科2008年8月至2009年10月在我科接受手術治療,術前經(jīng)多層螺旋CT檢查,術后病理檢查證實為膽脂瘤型中耳炎的71例患者為研究對象。根據(jù)每位研究對象的顳骨多層螺旋CT影像學資料,仔細閱讀膽脂瘤病變部位、聽骨鏈破壞情況及中耳毗鄰骨質(zhì)受侵情況等,回顧性對照術中在耳科手術顯微鏡下所見情況,評估術前診斷與術中所見的診斷符合率。 [結(jié)果]術前CT診斷膽脂瘤病變部位128個,而術中證實為124個,符合率為93.5%；術前CT診斷聽骨鏈破壞183個,而術中證實為167個,診斷符合率為88%；術前CT診斷中耳毗鄰骨質(zhì)受侵部位147個,術中證實為135個,診斷符合率為91.9%。 [結(jié)論]對于膽脂瘤型中耳炎,多層螺旋CT影像學診斷與耳科手術顯微鏡下所見基本一致,多層螺旋CT能直觀、準確地顯示膽脂瘤病變部位、聽骨鏈破壞情況以及毗鄰骨質(zhì)破壞的范圍,是可靠的診斷方法,對制定手術方案和評估治療效果,具有重要的指導意義。
[Abstract]:[Objective] to evaluate the coincidence rate between preoperative diagnosis and intraoperative diagnosis of cholesteatoma otitis media by comparing the imaging diagnosis of multi-slice spiral CT with that of the operation under the microscope. To explore the clinical value of multi-slice spiral CT in the diagnosis of cholesteatomatous otitis media invasion and the degree of bone destruction, and to provide a reference standard for the selection of surgical methods, approach and prognosis. [Methods: the department of otolaryngology and otolaryngology of the first affiliated Hospital of Kunming Medical College was operated in our department from August 2008 to October 2009 and was examined by multi-slice spiral CT before operation. After operation, 71 patients with cholesteatoma type otitis media proved by pathological examination were studied. According to the imaging data of multi-slice spiral CT of temporal bone of each patient, the location of cholesteatoma was carefully read. The destruction of ossicular chain and the condition of osseous invasion adjacent to middle ear were analyzed retrospectively. The coincidence rate between preoperative diagnosis and intraoperative diagnosis was evaluated. [Results: 128 lesions of cholesteatoma were diagnosed by CT before operation, while 124 were proved during operation, the coincidence rate was 93.5. Preoperative CT diagnosis of ossicular chain destruction 183, but intraoperative proved 167, the diagnostic coincidence rate is 88. Preoperative CT diagnosis of 147 sites adjacent to the middle ear, 135 confirmed during the operation, the diagnostic coincidence rate was 91.9%. [Conclusion: for cholesteatoma otitis media, the imaging diagnosis of multi-slice spiral CT is consistent with that under the microscope of ear surgery. Multi-slice spiral CT can visualize and accurately display the location of cholesteatoma. The destruction of ossicular chain and the extent of adjacent bone destruction are reliable diagnostic methods.
【學位授予單位】：昆明醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R764.21

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