耳源性病变脑膜受累的影像分析  

Imaging analysis of meningeal involvement in otogenic lesions

作　　者：陈秀英[1] 袁庆海[1] 袁碧营 陈杰[1] 张鹏[1] CHEN Xiu-ying;YUAN Qing-hai;YUAN Bi-ying;CHEN Jie;ZHANG Peng(Department of Radiology,the Second Hospital of Jilin University,Changchun 130000,China)

机构地区：[1]吉林大学第二医院放射线科,吉林长春130000

出　　处：《中国临床医学影像杂志》2023年第12期837-840,864,共5页Journal of China Clinic Medical Imaging

基　　金：吉林大学横向课题(编号:2022YX0207)。

摘　　要：目的:分析耳源性病变累及脑膜的影像特点,提高耳部病变的影像诊断效能,并进一步探讨耳部胆脂瘤累及脑膜的危险因素。方法:收集2020年1月—2023年1月于我院行耳部MRI平扫加弥散加增强检查以及颞骨CT平扫检查患者的影像资料,统计有脑膜受累且有术后病理的耳源性疾病患者的影像及临床信息,回顾分析其脑膜受累的影像特点,同时收集CT上有鼓室顶盖破坏但无脑膜受累的耳部胆脂瘤患者的影像及临床信息,回顾分析耳部胆脂瘤累及脑膜的危险因素。结果:累及脑膜的耳肿瘤性病变主要为鳞状细胞癌,非肿瘤组与肿瘤组增厚强化脑膜的冠状径线与骨质破坏最大冠状径线比值(Rc)、增厚强化脑膜的矢状径线与骨质破坏最大矢状径线比值(Rs)及最大厚度有统计学差异,Z值分别为2.05、2.15、3.09,P均<0.05。耳部胆脂瘤患者脑膜强化组与不强化组间性别、吸烟史均无统计学差异,χ^(2)值分别为0.50、0.42,P均>0.05;两组间胆脂瘤平均径线(Rm)、鼓室顶盖破坏平均径线(Dm)均无统计学差异(Z=1.13、0.89,P均>0.05);两组间鼓室顶盖破坏处肉芽组织厚度存在明显统计学差异(Z=5.94,P<0.001)。结论:耳部恶性肿瘤与非肿瘤性病变导致脑膜增厚强化的影像表现不同,前者受累脑膜增厚程度更大,但相对于骨质破坏范围的脑膜强化范围小于后者。鼓室顶盖破坏处存在肉芽组织是中耳胆脂瘤患者脑膜受累的危险因素。Objective:To analyze the imaging features of meningitis involved by otogenic lesions to improve the imaging diagnostic efficiency of ear lesions.Investigate the risk factors of meningitis caused by ear cholesteatoma.Methods:Imaging data of patients who underwent ear magnetic resonance plain scan plus diffusion and enhancement examination and CT plain scan of temporal bone in our hospital from January 2020 to January 2023 were collected.Imaging and clinical information of patients with otogenetic diseases with meningeal involvement and postoperative pathology were collected and retrospectively analyzed,and imaging characteristics of meningeal involvement were retrospectively analyzed.At the same time,the imaging and clinical information of patients with middle ear cholesteatoma with destruction of the tympanic roof on CT but no meningeal involvement on MRI were collected,and the risk factors of meningitis caused by middle ear cholesteatoma were retrospectively analyzed.Results:The neoplastic lesions of the ear involving the meninges are mainly squamous cell carcinomas.There were statistical differences in coronal diameter of thickened and enhanced meninges/maximum coronal diameter of bone destruction(Rc),sagittal diameter of thickened and enhanced meninges/maximum sagittal diameter of bone destruction(Rs)and maximum thickness between non-tumor group and malignant tumor group,with Z values of 2.05,2.15,3.09,P<0.05,respectively.As for ear cholesteatoma patients,there were no significant differences in gender and smoking history between the meningeal enhancement group and non-meningeal enhancement group,χ^(2) values were 0.50 and 0.42,P>0.05,respectively.There was no significant difference in the mean diameter of cholesteatoma(Rm)and the mean diameterof tympanical roof destruction(Dm)(Z=1.13,0.89 respectively,P>0.05).The granulation tissue thickness of the damaged tympanic roof was significantly different between the two groups(Z=5.94,P<0.001).Conclusion:The imaging manifestations of meningeal thickening and enhance

关 键 词：耳疾病 脑膜 体层摄影术 X线计算机 磁共振成像 

分 类 号：R764[医药卫生—耳鼻咽喉科] R814.42[医药卫生—临床医学] R445.2