74例放射性鼻窦炎CT检查分析  

CT scan study of radiation nasosinusitis in 74 cases

作　　者：张学辉[1] 肖树朋[2] 傅向军[1] 黄健男[1] 

机构地区：[1]广东省第二人民医院耳鼻咽喉头颈外科,广东广州510310 [2]南华大学医学院研究生院,湖南衡阳421001

出　　处：《中国耳鼻咽喉颅底外科杂志》2009年第4期276-278,283,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：广东省医学科研基金课题(A2007149)

摘　　要：目的探讨放射性鼻窦炎的CT影像学特征。方法总结74例经放射治疗后18个月以上的鼻咽癌病例,分4个阶段完成鼻窦CT扫描,将影像资料进行Lund-Mackay评分。结果各阶段放射性鼻窦炎发生率最高的部位是上颌窦,其次是前组筛窦、后组筛窦和蝶窦,额窦发生率最低。窦口鼻道复合体阻塞率与上颌窦炎成正向升高,随放射治疗后时间的后延,各组Lund-Mackay评分数据亦随之上升,重度浑浊例数逐渐增多,至第四阶段评分数据开始回落,放射性鼻窦炎处于静止期或恢复期。结论CT扫描能够显示鼻窦解剖结构和变异情况,能追踪观察放射性鼻窦炎的客观变化。Lund-Mackay评分系统适合于影像学大范围大宗病例的流行病学调查。Objective To investigate the imaging features of radation nasosinusitis by CT scan. Methods Seventy- four eases of nasopharyngeal cancer patients , who were treated with radiation for more than 1 8 months were given paranasal sinus CT scan at four stages. Imaging data was accessed with Lund- Mackay score. Results Radiation nasosinusitis at various stages most occurred in the maxillary sinus, followed by anterior ethmoid sinus and posterior ethmoid sinus , sphenoidal sinus, and least in frontal sinus. The rate of maxillary sinusitis increased along with the rate of ostiomeatal complex blocking. Lund- Mackay score of all groups increased as the extension of the time after radiotherapy. Similarly severe turbid cases were gradually increased. At the fourth stage, the Lund- Mackay score started to dropped down, indicating radiation nasosinusitis was in a quiescent or recovery period. Conclusion CT scan can show the dynamic anatomy variation of sinus that followed the objective change of radiation nasosinusitis. Lund- Mackay scoring system is suitable for epidemiologieal survey for large- scale of eases of imageology.

关 键 词：鼻咽癌 放射性鼻窦炎 断层摄影术 

分 类 号：R765.4[医药卫生—耳鼻咽喉科] R445.3[医药卫生—临床医学]