自身免疫性疾病相关中耳乳突炎的影像学分析  

Imaging findings of otitis media associated with immune disease

作　　者：李静[1] 唐欣薇 吴晓华[1] 王振常[1] LI Jing;TANG Xinwei;WU Xiaohua;WANG Zhenchang(Department of Radiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,P.R.China)

机构地区：[1]首都医科大学附属北京友谊医院放射科,北京100050

出　　处：《医学影像学杂志》2021年第7期1107-1110,共4页Journal of Medical Imaging

基　　金：国家自然科学基金资助项目(编号:81800840)。

摘　　要：目的探讨自身免疫性疾病所致中耳炎的影像学表现,增强放射科医师对该疾病的认识。方法选取2000年~2019年15例自身免疫性疾病(2例嗜酸性中耳炎、4例IgG4相关疾病、9例坏死性肉芽肿性血管炎)相关中耳乳突炎患者的影像学资料和临床表现。结果11例患者为双侧、4例患者为单侧中耳乳突炎,CT表现为鼓室、乳突蜂房和鼓窦内软组织影填充,听小骨和中耳乳突区骨质未见破坏征象,MRI表现为T1WI低信号,T2WI高信号,当分泌物较粘稠时MRI信号混杂。2例嗜酸性中耳炎可见鼻窦术后表现。4例IgG4相关疾病头颈部异常表现包括双侧腮腺、颌下腺、泪腺肿大;三叉神经分支额神经、眶下神经增粗;鼻窦炎症等。9例坏死性肉芽肿性血管炎头颈部异常表现包括眼眶肌锥外间隙受累、鼻中隔骨质破坏及脑膜增厚强化,双侧或单侧泪腺肿大。结论多种自身免疫性疾病均可导致中耳乳突炎,每种疾病头颈部伴随的改变各具特点,全面细致的观察视野内所有异常改变,有助于得出正确的诊断。Objective The purpose of this study is to describe the imaging findings of otitis media caused by immune disease.Methods We conducted a retrospective case review.The subjects comprised 15 patients.Two patients were eosinophilic otitis media,four patients were IgG4 related disease(IgG4-RD)and 9 patients were necrotizing granulomatous vasculitis(NGV).The computed tomography images and magnetic resonance images were analyzed.Results Otitis media associated with immune disease had no bony erosion and the sclerotic mastoid.EOM was associated with adult bronchial asthma and nasal allergies.In IgG4-RD patients,the other abnormalities in the head and neck included the trigeminal nerve and its branches involved,enlargement of the lacrimal gland,submandibular gland and parotid gland.In NGV patients,the other abnormalities in the head and neck included inflammatory pseudotumor in extrapyramidal space,lacrimal gland involved and meningeal thickening.Conclusion Otitis media could be caused by many immune diseases.It is important to observe carefully all the structures in the imagings because every kind immune diseases will involve different structures.

关 键 词：嗜酸性中耳炎 IgG4相关疾病 坏死性肉芽肿性血管炎 影像学检查 

分 类 号：R764.2[医药卫生—耳鼻咽喉科] R445[医药卫生—临床医学]