本文關(guān)鍵詞： 鼻竇 息肉 體層攝影術(shù) X線計(jì)算機(jī) 磁共振成像　出處：《臨床耳鼻咽喉頭頸外科雜志》2017年15期 　論文類型：期刊論文

【摘要】：目的:探討上頜竇出血性息肉的CT、MRI表現(xiàn),總結(jié)影像學(xué)特點(diǎn),為臨床診斷提供幫助。方法:回顧性分析27例經(jīng)手術(shù)病理證實(shí)的上頜竇出血性息肉CT、MRI影像學(xué)資料。針對(duì)病變部位、形狀、范圍,竇壁骨質(zhì)改變,病變邊緣及周圍結(jié)構(gòu)情況,病變密度或信號(hào),各期增強(qiáng)掃描的強(qiáng)化方式、幅度及范圍進(jìn)行統(tǒng)計(jì)分析。結(jié)果:27例患者均為單側(cè)發(fā)病。均行CT平掃,其中9例行雙期動(dòng)態(tài)增強(qiáng)CT檢查,11例行MRI檢查,其中6例行MRI增強(qiáng)檢查。CT平掃見單側(cè)上頜竇充滿等低混雜密度影并累及鼻腔,上頜竇不均勻膨大變形,伴局部骨質(zhì)吸收破壞27例,但未侵犯鄰近結(jié)構(gòu),CT增強(qiáng)掃描病變內(nèi)見點(diǎn)片狀血管樣顯著強(qiáng)化及進(jìn)行性強(qiáng)化。MRI能清楚區(qū)分病變及阻塞性鼻竇炎,病變均形態(tài)不規(guī)則,呈混雜信號(hào),T1WI主要為中等信號(hào)8例、稍低信號(hào)3例,混雜少量高信號(hào);T2WI呈高低混雜信號(hào),邊緣見不規(guī)則低信號(hào)環(huán)。增強(qiáng)呈多發(fā)結(jié)節(jié)狀、斑片狀不均勻明顯強(qiáng)化。結(jié)論:上頜竇出血性息肉CT顯示實(shí)變上頜竇不規(guī)則膨大變形伴骨質(zhì)壓迫吸收對(duì)本病有一定提示作用,血管樣顯著強(qiáng)化及進(jìn)行性強(qiáng)化是本病的特征性增強(qiáng)CT表現(xiàn),MRI具有非常典型的影像學(xué)表現(xiàn),T2WI呈高低混雜信號(hào)和低信號(hào)環(huán),增強(qiáng)呈多發(fā)結(jié)節(jié)狀、斑片狀不均勻明顯強(qiáng)化,能清楚地顯示病變與周圍軟組織無侵犯征象。具有較好的診斷價(jià)值。術(shù)前CT和MRI檢查對(duì)該病的術(shù)前診斷有重要意義。
[Abstract]:Objective: to investigate the CT MRI features of hemorrhagic polyps of maxillary sinus and summarize the imaging features. Methods: the imaging data of 27 cases of maxillary sinus hemorrhagic polyp confirmed by surgery and pathology were analyzed retrospectively, according to the location, shape, range and bone changes of sinus wall. The edge and surrounding structure of the lesion, the density or signal of the lesion, the enhancement mode, the amplitude and the range of each phase of enhanced scan were statistically analyzed. Results all the 27 cases of disease were unilateral and all underwent plain CT scan. Among them, 9 cases were examined by dual phase dynamic contrast-enhanced CT and 11 cases by MRI, among them, 6 cases were examined by MRI. Ct plain scan showed that unilateral maxillary sinus was filled with low mixed density and involved nasal cavity. The maxillary sinus was inhomogeneous enlarged and deformed, accompanied by local bone resorption and destruction in 27 cases, but did not invade the adjacent structure. Enhanced CT scan showed patchy enhancement and progressive enhancement. MRI could clearly distinguish the lesions from obstructive sinusitis. The lesions were irregular in shape and showed mixed signal. T1WI mainly showed moderate signal intensity in 8 cases, slightly low signal intensity in 3 cases, mixed with a small amount of high signal intensity. T2WI showed high and low mixed signal intensity, irregular hypointensity ring at the edge and multiple nodular enhancement. Conclusion: Ct of hemorrhagic polyp of maxillary sinus shows irregular enlargement of maxillary sinus with bone compression and absorption. Vascular-like enhancement and progressive enhancement are the characteristic CT features of this disease. MRI is a typical imaging manifestation with high and low signal intensity and low signal loop on T _ 2WI and multiple nodules on contrast enhancement. The patchy uneven enhancement can clearly show the lesion and the surrounding soft tissue without the signs of invasion. It has good diagnostic value. Preoperative CT and MRI are important for the preoperative diagnosis of the disease.
【作者單位】： 中國(guó)醫(yī)科大學(xué)附屬盛京醫(yī)院耳鼻咽喉頭頸外科;
【分類號(hào)】：R445.2;R765;R816.96
【正文快照】： 臨床耳鼻咽喉科雜志,1998,12(2):90-91.[10]HOSEMANN W,SCOTTI O,BENTZIEN S.Evalua-tion of telescopes and forceps for endoscopic tran-snasal surgery on the maxillary sinus[J].Am J Rhi-nol,2003,17:311-316.[11]古慶家,李靜嫻,樊建剛,等.單側(cè)上頜竇良性占位性病變手

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