鼻腔鼻窦内翻性乳头状瘤生发中心的CT诊断  

Diagnostic of the origin on CT to sinonasal inverted papilloma

作　　者：李晶玉[1] 何福芹[1] 张念凯[1] 

机构地区：[1]青岛大学医学院附属医院耳鼻咽喉头颈外科,山东青岛266003

出　　处：《山东大学耳鼻喉眼学报》2013年第2期40-42,48,共4页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：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 precisely localize the origin of sinonasal inverted papilloma（SIP） by preoperative CT imaging so that the tumor can be thoroughly excised and result in low tumor recurrence. Methods Sinonasal CT imagines of 25 patients were retrospectively reviewed to contract with the true origin, and the CT values of tumor origin and non-origi- nal tissue were calculated and the CT imagines were observed. Results CT values were（36.87 ± 10.21 ） HU at tumor origin, which demonstrated a higher density on CT imagines and appeared grey-white, and were （25.32 ±10.69 ）HU at the non-original tissue of the tumor, which showed a low density shadow and appeared grey-black. Using paired sam- ples test, there were statistical differences between the two groups （P 〈 0.05 ） ; 6 in 20 initial cases presented focal hy- perostosis ,4 of these cases coincided with the origin of tumor, the Consistency was up to 66.7%, 6 cases had air sign （24%） ,10 cases had bone displacement（40% ） and 10 cases had bone destruction. Conclusion CT values at the ori- gin of SIP are higher than those at the non-original tissues, associated with bone changes. Air sign is helpful in detecting the tumor origin and making operation plans.

关 键 词：鼻腔 鼻窦 乳头状瘤 内翻 体层摄影术 X线计算机 

分 类 号：R739.62[医药卫生—肿瘤]