螺旋CT设备诊断霉菌性鼻窦炎的确诊率及影像学特征  

Diagnostic Rate and Imaging Features of Spiral CT in Fungal Sinusitis

作　　者：王勇 刘彬[2] WANG Yong;LIU Bin(Department of Radiology,Hangu Hospital of Traditional Chinese Medicine,Binhai New District,Tianjin 300480,China;Department of Medical Imaging,the Second Hospital of Qinhuangdao,Qinhuangdao 066600,Hebei,China)

机构地区：[1]天津市滨海新区汉沽中医医院放射科,天津300480 [2]秦皇岛市第二医院医学影像科,河北秦皇岛066600

出　　处：《医学信息》2022年第17期135-137,共3页Journal of Medical Information

摘　　要：目的 探究基于病理标准分析螺旋CT设备对霉菌性鼻窦炎的确诊率及影像学特征。方法 回顾分析2018年4月-2020年4月秦皇岛第二医院收治的44例霉菌性鼻窦炎患者临床资料,均经病理诊断确诊,所有患者均行螺旋CT诊断检查,观察内镜检查结果、螺旋CT诊断确诊率、敏感度、特异性,分析霉菌性鼻窦炎CT影像学特征。结果 螺旋CT诊断确诊率为95.45%,敏感度为90.90%,特异性为95.23%;其中单发病例36例,占85.71%,多发病例6例,占14.28%;主要累及病变部位为上颌窦(71.42%),其次依次为≥2个副鼻窦腔(19.04%)、后鼻孔(9.52%);霉菌性鼻窦炎CT影像主要表现为:窦腔内可见高密度、不均匀软组织块影,或黏膜明显增厚,伴密度不均的沙粒状、索条状或斑点状钙化病灶;窦壁骨质有硬化、吸收、破坏改变;病灶中可见多种变异,主要包括中、下鼻甲肥大、中鼻甲气化、鼻中隔偏曲、钩突肥大。结论 螺旋CT设备对霉菌性鼻窦炎诊断率、敏感度、特异性均为90%以上,具有较高的诊断效能,可有效降低误诊或漏诊率,明确病变累及部位。同时CT影像学特点,可为霉菌性鼻窦炎的鉴别诊断提供一定参考依据。Objective To explore the diagnostic rate and imaging characteristics of mycotic sinusitis with spiral CT based on pathological criteria.Methods The clinical data of 44 patients with fungal sinusitis admitted to the Second Hospital of Qinhuangdao from April 2018 to April 2020 were retrospectively analyzed.All patients were diagnosed by pathological diagnosis,and all patients underwent spiral CT diagnosis.The results of endoscopic examination,spiral CT diagnosis rate,sensitivity and specificity were observed,and the CT imaging features of fungal sinusitis were analyzed.Results The diagnostic rate of spiral CT was 95.45%,the sensitivity was 90.90%,and the specificity was 95.23%.Among them,36 cases were single cases,accounting for 85.71%,6 cases were multiple cases,accounting for 14.28%;the main lesion site was maxillary sinus(71.42%),followed by ≥2 accessory sinus cavity(19.04%) and posterior nostril(9.52%).The CT images of fungal sinusitis were mainly as follows:high density,uneven soft tissue mass in sinus cavity,or obvious thickening of mucosa,with uneven density of sandy,cord-like or punctate calcification lesions;sinus wall bone sclerosis,absorption,destruction change;a variety of variations can be seen in the lesions,including middle and inferior turbinate hypertrophy,middle turbinate gasification,nasal septum deviation,uncinate process hypertrophy.Conclusion The diagnostic rate,sensitivity and specificity of spiral CT equipment for fungal sinusitis are all above 90%.It has high diagnostic efficiency,which can effectively reduce the rate of misdiagnosis or missed diagnosis and clarify the location of lesions.At the same time,CT imaging features can provide some reference for the differential diagnosis of fungal sinusitis.

关 键 词：霉菌性鼻窦炎 病理标准 螺旋CT 确诊率 影像学特征 

分 类 号：R765.41[医药卫生—耳鼻咽喉科] R816.96[医药卫生—临床医学]