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目的术前通过CT值对内翻性乳头状瘤的根蒂即生发中心定位,尽可能完整切除肿瘤,降低术后复发概率。方法回顾性分析25例鼻腔鼻窦内翻性乳头状瘤的CT资料,计算术中确定的肿瘤根蒂部位CT值与非根蒂部CT值,并观察肿瘤在CT图像上的灰度变化。结果肿瘤根蒂部组织CT值平均为(36.87±10.21)HU,在CT图像上可表现出较高密度影,呈现灰白色,肿瘤非根蒂部组织CT值平均为(25.32±10.69)HU,在CT图像上可表现出较低密度影,呈现灰黑色,经配对t检验,两组数据差异有统计学意义(P<0.05);20例初发病例中局部骨增生者6例(30%),其中有4例与肿瘤根蒂一致,一致性达66.7%,25例中有气泡征者6例(24%),骨质移位者14例(56%),骨质破坏者10例(40%)。结论鼻腔鼻窦内翻性乳头状瘤的肿瘤根蒂部CT值较高,CT图像上为高密度影,可联合骨质变化及气泡征来判断肿瘤根蒂部位,制定手术方案。
Objective To preoperative CT value of inverted papilloma root that hair center, as complete resection of the tumor, reduce the probability of postoperative recurrence. Methods The CT data of 25 patients with inverted papilloma of the nasal cavity were retrospectively analyzed. The CT value and the non-pedicle CT value of the pedicle of the tumor were calculated and the changes of the grayscale in the CT images were observed. Results The CT value of the pedicle of the tumor was (36.87 ± 10.21) HU on average, which showed a higher density on CT images. The CT value of the non-pedicle tissue was (25.32 ± 10.69) HU, CT images showed a lower density, showing a gray-black, paired t-test, the difference between the two groups was statistically significant (P <0.05); 20 cases of primary bone hyperplasia in 6 cases (30% , Of which 4 cases were consistent with the tumor pedicle, the consistency was 66.7%, there were 6 cases (24%) of them with blister syndrome in 25 cases, 14 cases (56%) of the bone displacement and 10 cases of the bone destruction 40%). CONCLUSIONS: Nasal sinus inverted papilloma has a high CT value in the pedicle of the tumor and a high density on the CT image. It can be used to determine the position of the root of the tumor in combination with the change of the bone mass and the blister sign to make the surgical plan.