【摘要】 目的:探讨CT在霉菌性和慢性化脓性鼻窦炎鉴别诊断。方法:对52例经手术后病理证实为霉菌性和慢性化脓性鼻窦炎患者的影像学、临床及手术病理资料进行回顾性分析。结果:霉菌性和慢性化脓性鼻窦炎CT表现的差异主要在以下3个方面:(1)病变范围:霉菌性鼻窦炎受累情况以单窦病变为主,66.7%的病例病变累及单侧上颌窦;慢性化脓性鼻窦炎多为双侧多鼻窦受累,79.4%病例病变累及双侧多个鼻窦。(2)病变密度:慢性化脓性鼻窦炎窦腔黏膜增厚、软组织团块影的密度均匀、无钙化灶;78.9%的霉菌性鼻窦炎的窦腔病变中有条带状、斑点状或团块状的高密度钙化影。(3)窦壁骨质的受累状况:化脓性鼻窦炎病例中未见窦腔骨质破坏;而霉菌性鼻窦炎病例中,44.4%的病例有不同程度的骨质吸收和破坏,位于上颌窦内侧壁。结论:CT扫描对霉菌性和慢性化脓性鼻窦炎的鉴别诊断有一定的价值。更多还原

【Abstract】 Objective:To study the role of computer tomography(CT) in differential diagnosis of mycotic paranasal sinusitis and chronic suppurative paranasal sinustis.Methods:The CT characteristics of 18 cases of mycotic paranasal sinusitis and 34 cases of chronic suppurative paranasal sinustis diagnosed with pathologic examination were retrospectively analyzed.Results: There were three differente aspects of CT characteristics in mycotic paranasal sinusitis and chronic suppurative paranasal sinustis.(1)Extent of disease: mycotic paranasal sinusitis mainly destroyed single side of sinus,66.7% cases infected unilateral maxillary sinus;the damage of chronic suppurative paranasal sinusitis mainly were bilateral maxillary sinus,79.4% cases have polysinus were involved.(2) Density of the damage: sinus opacification frequently heterogeneous,fluid trapping,and with pseudotumoral appearance and highly calcification in 78.9% fungal paranasal sinusitis.while chronic suppurative paranasal sinusitis showed mucosal thickening and adqulis pseudotumoral appearance without calcification.(3) Bony changes: bone damage was seldom seen in chronic suppurative paranasal sinusitis.44.4% cases of fungal paranasal sinusitis have bone changing in medial wall of maxillary sinus.Conclusion:CT scan has some role in diagnosing and differentitation of mycotic paranasal sinusitis from chronic suppurative paranasal sinustis.更多还原