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目的 探讨CT所见骨质改变对鼻腔和副鼻窦良、恶性病变的鉴别诊断价值。材料与方法 经病理证实的鼻腔及副鼻窦良、恶性病变 131例 ,在CT图像上盲法观察各种骨质改变的类型、范围和部位。结果 良、恶性病变有骨质破坏者分别占 6 5 .2 %和 84.7% ;6 6 .7% ,恶性病变的骨质破坏呈多发性 ,良性组以单发为主 (73 .3 % ) ;良、恶性病变突破窦壁的发生率分别是 2 1.7%和 5 2 .9% ;上颌窦内侧壁、筛窦间隔和鼻甲骨质破坏的发生率良、恶性组相似 ,其他骨壁骨质破坏恶性组多于良性组。骨膨胀的发生率两组相近 ,而良性组的骨质硬化多于恶性组 ,神经孔、裂扩大恶性组多于良性组。结论 根据骨质破坏的不同类型、部位和范围 ,CT对鼻腔和副鼻窦良、恶性病变的鉴别诊断可提供较大的帮助。
Objective To investigate the differential diagnosis of benign and malignant lesions of the nasal cavity and paranasal sinuses with bone changes seen by CT. Materials and Methods Thirty-one cases of benign and malignant nasal and paranasal sinus lesions were confirmed by pathology. The types, ranges and locations of various bone changes were blindly observed on CT images. Results Sixty-two percent and 84.7% of the patients had benign and malignant lesions with bone destruction, respectively. Sixty-six to seven percent of them were malignant lesions. The bone destruction of malignant lesions was multiple and the benign ones were mainly single (73.3%). The prevalence of benign and malignant lesions breaking through the sinus wall was 21.7% and 52.2% respectively. The incidence of maxillary sinus medial wall, ethmoid sinus space and turbinate bone destruction was good, similar to the malignant group, Destructive malignant group than the benign group. The incidence of bone swelling was similar between the two groups, while in the benign group, there was more bone sclerosis than in the malignant group, neuroporosity and malignant enlargement group than in the benign group. Conclusion According to the different types, locations and ranges of bone destruction, CT can provide a great help in the differential diagnosis of benign and malignant lesions of nasal and paranasal sinuses.