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目的 :探讨鼻腔副鼻窦CT检查方法和肿瘤的形态、密度、窦壁骨质破坏、周围脂肪层侵犯、窦腔外软组织肿块等征象在鼻腔副鼻窦恶性肿瘤中的诊断作用。材料与方法 :逐项对比观察分析经病理证实的鼻腔副鼻窦恶性肿瘤 3 2例和良性肿物 13 9例的CT表现。结果 :CT冠状位扫描显示 15例恶性肿瘤破坏 2 5个窦腔骨壁 ,2 0例腔外软组织肿块累及 2 3个相邻部位。轴位扫描发现骨壁受累 12例 ,有 2 0个侧壁骨质显示破坏 ,15个腔外肿块累及 18个相邻结构。恶性组和良性组突出于窦腔外的软组织肿块分别为 71 9%和 5 0 %、窦壁骨质侵蚀性破坏 5 9 4%和 14 4%、窦腔周围脂肪层的侵犯消失 5 6 3 %和 13 7% ,而软组织肿块形态不规则和密度不均匀 ,两组间无显著差异。结论 :鼻腔副鼻窦腔外软组织肿块、侵蚀性骨质破坏和窦壁周围脂肪层的侵犯消失 ,是诊断鼻腔副鼻窦恶性肿瘤的可靠征象。冠状扫描观察解剖内容和病变侵犯范围优于轴位扫描。
Objective: To investigate the CT findings of nasal paranasal sinuses, and the diagnostic value of tumor morphology, density, destruction of sinus bone wall, invasion of peripheral fat layer, extra-infarct soft tissue mass, and other signs in nasal cavity and paranasal sinuses. Materials and Methods: The CT findings of pathologically confirmed nasal paranasal sinus malignant tumors in 32 cases and benign tumors in 139 cases were compared and analyzed one by one. Results: CT coronal scan showed that 15 malignant tumors destroyed 25 sinus bone walls, and 20 extraluminal soft tissue masses involved 23 adjacent sites. Axial scanning revealed 12 cases of bone wall involvement, 20 of the lateral wall bones showing destruction, and 15 extraluminal masses involving 18 adjacent structures. Malignant and benign groups had 71% and 50% of soft tissue masses protruding beyond the sinus cavity, 59.44% and 144% of erosions of the sinus wall, and disappearance of fat layers around the sinus 5 6 3 . % and 13%, while soft tissue masses were irregular in shape and density, there was no significant difference between the two groups. Conclusion: The extranasal paranasal sinus extraluminal soft tissue masses, aggressive bone destruction and disappearance of the fat layer around the sinus wall are the reliable signs for the diagnosis of malignant nasal paranasal sinuses. Coronal scans were superior to axial scans in terms of anatomical content and extent of lesion invasion.