慢性鼻-鼻窦炎患者鼻窦骨质改变的放射学评估  

The radiologic evaluation of bony density change in chronic rhinosinusitis

作　　者：田鹏[1] 邹华[1] 刘翔[1] 陈秋坚[1] 谢存存[1] 潘忠[1] 王静怡[1] 

机构地区：[1]中山大学孙逸仙纪念医院耳鼻咽喉头颈外科,广州510120

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第22期1793-1796,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：广东省自然科学基金博士启动项目(No:2015A030310125);广东省自然科学基金自由申请项目(No:2014A030313158)

摘　　要：目的:探讨慢性鼻-鼻窦炎患者鼻窦骨质改变的特点,明确鼻窦骨质改变与鼻窦腔引流状态的关系。方法:慢性鼻-鼻窦炎患者210例,正常对照组40例,利用PHILIPS MxLiteView软件分析术前鼻窦CT,测量鼻窦骨质拟研究部位CT值;同时采用SPSS 13.0软件分析不同引流状态的鼻窦骨壁HU值的差异。结果:对于前组筛窦,软组织影组眶纸板HU值(203.82±34.80)明显高于正常对照组(14.12±13.05)和无软组织影组(16.00±12.04),均差异有统计学意义(P<0.05)。对于后组筛窦,软组织影组眶纸板HU值(209.41±45.31)明显高于正常对照组(15.13±11.15)和无软组织影组(20.41±15.31),差异有统计学意义(P<0.05)。对于额窦,软组织影组额窦后壁骨质HU值(1 161.8±65.75)高于正常对照组(551.00±59.60)和无软组织影组(641±68.40),差异有统计学意义(P<0.05)。结论:慢性鼻-鼻窦炎鼻窦骨质HU值在有软组织影的鼻窦,即存在黏膜顽固病变和(或)引流障碍的鼻窦,出现骨质信号的改变,提示鼻窦的引流障碍与鼻窦骨质HU值改变有关。该部位HU值的改变可能提示相应窦腔黏膜病变的不可逆,可能是判断是否需行鼻内镜手术的客观标志。Objective：To correlate abnormal bone density of sinus wall with impaired drainage of sinus cavity.Method：A retrospective radiological study was conducted：pre-operative CT scans of 210 patients with chronic rhinosinusitis（CRS）and CT scans of 40age-and gender-matched individuals（normal group）without sinonasal disease were reviewed.Opacification of the paranasal sinuses and the radiological density of sinus wall were evaluated and analyzed using PHILIPS MxLite View software.Result：The Hounsfield Units obtained from the lamina papyracea in opaque anterior ethmoid sinus and posterior ethomid sinus were statistically significantly higher than that of the no opacification population in AES and PES and that of the normal group.Secondly,the Hounsfield Units of posterior wall in the opaque frontal sinus in patients with CRS were statistically significantly higher than that of the no opacification CRS patient group and the normal group.Conclusion：Inflammatory bone density changes in CRS patients were observed in the opaque sinuses,and few were found in the sinuses that were not opaque sinuses,suggesting that osteitis mainly occurs in sinuses with drainage disorder or mucosa disease.These change implied that HU change might be a mark of intractable disease and surgery.

关 键 词：慢性鼻-鼻窦炎 骨炎 放射学 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]