鼻腔及鼻窦内翻性乳头状瘤CT误诊分析

目的　探讨鼻腔鼻窦内翻乳头状瘤的CT误诊原因。方法　对 10例病理证实为鼻腔鼻窦内翻乳头状瘤而术前CT误诊的病例进行分析。结果　鼻腔鼻窦内翻乳头状瘤主要表现为单侧鼻腔鼻窦呈匍匐生长的软组织团块 ,轻到中度增强 ,可伴有骨质破坏和骨质硬化。结论　严格操作规程 ,行增强扫描 ,可降低本病的误诊率。     

鼻腔及副鼻窦内翻性乳头状瘤的CT表现(附15例分析)

鼻腔及副鼻窦内翻性乳头状瘤是一种起源于鼻腔及副鼻窦的少见的良性肿瘤 ,生长缓慢 ,但常大范围侵及鼻腔和鼻窦 ,可引起骨质改变 ,切除术后易复发 ,有恶变倾向。收集我院 1995～ 2 0 0 0年间经手术病理证实的 15例内翻性乳头状瘤的有关资料进行分析 ,旨在提高诊断水平。1　材料与方法　　本组男 11例 ,女 4例 ,年龄 2 8～ 78岁 ,平均 5 1岁。从症状出现到就诊时间 1个月至 2 0年不等 ,平均 6年。临床症状主要有鼻塞 15例 ,头痛 8例 ,鼻衄和面部麻木 5例 ,嗅觉丧失2例 ,流泪 1例。鼻腔内窥镜检查 :在一侧鼻腔内可见软组织肿物 ,其中左侧 8例 …     

鼻腔鼻窦内翻性乳头状瘤的临床特点及手术治疗

目的分析鼻腔鼻窦内翻性乳头状瘤的临床特点，探讨鼻内镜手术治疗的临床效果。方法回顾性分析本院2011-01～2012-12收治的30例鼻腔鼻窦内翻性乳头状瘤的临床基本资料。结果30例患者手术后无并发症发生，术后随访6～12个月，复发患者3例，复发率为10％。结论采用鼻内镜手术治疗鼻腔鼻窦内翻性乳头状瘤，疗效显著，值得临床推广。     

HRCT及MRI对鼻腔-副鼻窦出血坏死性息肉及内翻性乳头状瘤的鉴别诊断价值

目的探讨HRCT及MRI在鼻腔-副鼻窦出血坏死性鼻息肉及内翻性乳头状瘤鉴别诊断中的价值。方法对经手术病理证实的54例内翻性乳头状瘤及22例出血坏死性鼻息肉患者的一般资料、临床表现、HRCT及MRI影像资料进行回顾性分析。结果出血坏死性鼻息肉的发病年龄低于内翻性乳头状瘤(P0.05)。生长方式上,部分出血坏死性鼻息肉表现为膨胀性生长,而内翻性乳头状瘤则无此特点。病灶周围局部骨质破坏是内翻性乳头状瘤恶变的重要提示。在CT平扫上,出血坏死性鼻息肉密度高于内翻性乳头状瘤(P0.05),出血坏死性鼻息肉CT增强各期表现为渐进性强化,而内翻性乳头状瘤强化峰值出现于实质期,延迟期强化减低。MRI上出血坏死性鼻息肉中的出血成分表现为T1WI高信号,T2WI低信号,增强后表现为结节状明显不均匀强化,内翻性乳头状瘤表现为片状相对均匀强化。结论出血坏死性鼻息肉及内翻性乳头状瘤的影像学表现有一定区别,HRCT增强扫描及MRI在两者的鉴别诊断上有重要意义。     

唇下径路在鼻腔外侧壁切除术中的应用

鼻侧切开径路是治疗鼻腔和鼻窦肿瘤的一种常用径路,该径路术后遗留瘢痕畸形,面部美容效果差,对患者的心理和社交造成一定影响.1995-2000年,我们对36例病变局限可行鼻腔外侧壁切除术治疗的患者采用唇下径路的方法进行手术,效果满意.1 临床资料1.1 一般情况本组36例中男24例、女12例;年龄30～65岁,平均50.2岁.检查见鼻腔外侧壁向鼻腔内隆起,局部有坏死,部分病例鼻腔内充满淡红色新生物、质脆、易出血.活检:内翻性乳头状瘤20例,内翻性乳头状瘤伴恶变6例,鳞状细胞癌10例.CT检查:病变局限于鼻腔、筛窦和上颌窦内侧壁,眶下壁、筛板、上颌窦底壁、后外侧壁和前壁未见侵犯和骨质破坏.右侧24例、左侧12例.     

89例鼻腔及鼻窦内翻性乳头状瘤CT检查的价值

目的：评价ＣＴ对鼻腔及鼻突内翻性乳头状瘤的价值。材料与方法：对８９例经临床诊断为鼻腔及鼻窦内翻性乳头状瘤的患者均行横断及冠状位鼻窦ＣＴ扫描。结果；本组病例ＣＴ扫描均可见鼻腔、鼻窦内占位病变，经组织学证实为内翻性乳头状瘤。结论：ＣＴ扫描检查对准确估计病变程度、范围、预测预后及确定手术方案有肯定价值。     

Nd：YAG激光配合内镜手术治疗鼻内翻性乳头状瘤

ＮｄＹＡＧ激光配合内镜手术治疗鼻内翻性乳头状瘤林庆瑞近两年来，我科采用内镜鼻内进路，配合以ＮｄＹＡＧ激光的手术方法切除鼻腔及鼻窦的内翻性乳头状瘤，取得良好的效果，现报告如下：一般资料临床病理确诊为鼻腔及鼻窦内翻性乳头状瘤的４例患者，均为男性，病史１年...     

鼻腔内翻乳头状瘤的CT诊断(附23例分析)

鼻腔内翻乳头状瘤的ＣＴ诊断（附２３例分析）宋志巍李莉孙伯章鼻腔内翻乳头状瘤（ｉｎｖｅｒｔｅｄｐａｐｉｌ－ｌｏｍａ，简称ＩＰ）是一种起源于鼻腔侧壁，较为少见，相对良性的肿瘤，尽管生长缓慢，但常大范围侵及鼻腔和鼻窦，切除术后易复发，有恶变倾向。ＣＴ扫描可...     

内翻乳头状瘤的X线表现

作者报道242例鼻、鼻窦内翻乳头状瘤,将X线与手术发现作比较。30例具有平片、断层和CT扫描,4例仅作CT,4例未作X线检查。无论断层或CT均以5mm层厚扫描。初起症状多为鼻塞(78%)及鼻衄(16%),症状期1天～26年。肿瘤常见鼻腔侧壁(85%),常伴上颌窦、筛窦侵犯,41例为单侧性。术中发现骨破坏17例,术前均由CT 或断层显示。35例平片示鼻腔与同侧鼻窦混     

控制性低血压麻醉后诱发位置性眩晕1例

1 临床资料 患者,男性,55岁,因右侧鼻腔及上颌窦内翻性乳头状瘤入院。既往体健,否认高血压及心脏病史。查体心血管系统及全身各重要脏器未见异常。于全麻下行右鼻腔鼻窦内翻性乳头状瘤切除术。为预防术中过多出血,采用控制性低血压。手术顺利,出血200 ml,有效控制性低血压时程     

Focal hyperostosis on CT of sinonasal inverted papilloma as a predictor of tumor origin

BACKGROUND AND PURPOSE: To evaluate the CT characteristics of focal hyperostosis in patients with sinonasal inverted papilloma and to correlate these characteristics with the detection of the origins of tumors. MATERIALS AND METHODS: Paranasal sinus and nasal cavity CT images of 76 patients were reviewed retrospectively to detect areas within which there was focal hyperostosis. We correlated the sites on the CT scans within which there was focal hyperostosis with the origin of the tumors described in the corresponding patient's medical records. We also evaluated the CT features of focal hyperostosis according to the origin of tumors. RESULT: Surgical evaluation of 55 lesions with focal hyperostosis in CT images revealed that 49 of these lesions coincided with the actual origin of tumor. The CT-based determination of the locations of the areas of focal hyperostosis corresponded to the actual tumor origin in 89.1% of cases. Especially in cases with focal hyperostosis within the frontal, maxillary, sphenoid, and posterior ethmoid sinuses, areas of focal hyperostosis corresponded to the origin of tumor without exception. In the evaluation of the CT features of focal hyperostosis, 2 patterns of localized bone thickening were noted. Plaquelike bone thickening was seen mainly when focal hyperostosis involved the lateral wall of the nasal cavity. On the other hand, cone-shaped bone thickening was seen only in the walls of the paranasal sinuses or the bony septum. CONCLUSIONS: A high correlation between the origin of the inverted papilloma and focal hyperostosis on CT might facilitate preoperative prediction of tumor origin by radiologists and rhinologists.     

原发性鼻腔鼻窦恶性淋巴瘤的CT表现

目的:探讨鼻腔鼻窦恶性淋巴瘤的CT特点。材料和方法:回顾分析14例经病理证实鼻腔鼻窦淋巴瘤的CT表现。结果:鼻腔病灶12例,9例起源于鼻腔前部或鼻前庭,鼻窦腔病灶2例;病灶肿块表现4例,浸润表现3例,混合表现7例,多数(11/14)密度相对均匀;位于鼻窦腔者骨质破坏明显,2例均可见骨质缺损;位于鼻腔者骨质破坏不明显或较轻微,5例可见骨质吸收;病灶易累及邻近结构,6例鼻翼、鼻背部皮肤肿胀,皮下脂肪层消失,3例颊部软组织肿胀。结论:鼻腔鼻窦恶性淋巴瘤CT表现有一定特征性。     

Sinonasal computed tomography in patients with Wegener's granulomatosis

The goal of this study was to describe pathologies of sinonasal CT in patients with Wegener's granulomatosis. Between 1993 and 2004, sinonasal CT was performed in 28 patients (15 male, 13 female) with Wegener's granulomatosis. The following imaging findings were assessed on the CT scans: mucosal thickening, subtotal opacification, air-fluid level, bony destruction, sclerosing osteitis, bony thickening, orbital mass, and saddle nose deformity. Of the 28 patients, 61% showed mucosal thickening in the nasal cavity and 75% in the paranasal sinuses. A subtotal opacification of the paranasal sinuses was detected in 25%, and of the mastoid cells in 7% of patients. Fifty-seven percent of patients had bony destruction of the nasal cavity, and 54% of the paranasal sinuses. CT revealed sclerosing osteitis of the paranasal sinuses in 21%, and of the mastoid cells in 18% of patients. Bony thickening of the paranasal sinuses was detected in 18%, and of the mastoid cells in 14% of patients. With respect to all imaging findings, the maxillary sinuses were the most frequently affected paranasal sinuses. The authors conclude that the following sinonasal CT findings are observed in patients with Wegener's granulomatosis: (1) bony destruction, mainly of the nasal cavity, maxillary sinuses, and mastoid cells; (2) sclerosing osteitis, mainly of the maxillary sinuses and mastoid cells; (3) bony thickening, mainly of the maxillary sinuses and mastoid cells; and (4) mucosal thickening, mainly of the maxillary sinuses. These findings are, however, nonspecific and should be combined with other clinicopathologic and laboratory studies to confirm the diagnosis of Wegener's granulomatosis.     

鼻腔鼻窦原发恶性黑色素瘤的影像学表现

目的：分析鼻腔鼻窦原发恶性黑色素瘤CT及 MR 表现,探讨其诊断要点。方法回顾性分析经活检或手术病理及免疫组化证实的16例鼻腔鼻窦恶性黑色素瘤的CT、MR特征及临床资料,均行 CT 平扫及增强,其中9例行 MR 平扫及增强。结果16例CT表现均为单侧发病;肿瘤位于鼻腔8例,鼻窦4例,同时累及鼻腔、鼻窦4例;形态欠规整,呈软组织密度,其内未见钙化和囊变;周围组织均受侵;增强后不均匀中-重度强化。9例 MR表现均为单侧发病;肿瘤位于鼻腔4例,鼻窦3例,同时受累鼻腔、鼻窦2例;形态欠规则,1例呈T1 WI高信号,T2 WI低信号,3例呈T1 WI等信号,T2 WI等/稍高信号,5例呈混杂信号。增强后不均匀轻-中度强化;周围组织均有侵犯。结论鼻腔鼻窦原发恶性黑色素瘤 CT表现缺乏特异性;典型恶性黑色素瘤有 MR 特征性表现,但罕见,以非色素及混合型常见。CT联合 MRI能准确显示肿瘤部位及与周围组织、邻近骨质的关系。     

Aspergillosis of the paranasal sinuses

Summary The CT appearances of 13 cases of pathologically proven aspergillosis involving paranasal sinuses were reviewed. Symptoms included rhinorrhea, nasal obstruction, headache, facial pain and foul smell from the nose. At operation, these lesions appeared yellowish, brownish, grey or black in colour, and contained dirty or muddy material. Microscopic examination of the tissue removed showed anAspergillus ball with chronic inflammation but without invasion of the nasal or sinus mucosa in 6 cases, and tissue invasion with necrosis and inflammation in 7. The structures involved, in order of frequency, were: maxillary sinus, nasal cavity, ethmoid sinus, orbit and cavernous sinus. The orbit was involved in 2 cases, therefore categorized as invasive; the other 11 cases were non-invasive as judged by CT. Calcification was seen in the lesions of 9 cases. In most cases the adjacent bony structures showed areas of erosion and sclerosis. Aspergillosis should be suspected in the presence of a mass in the paranasal sinuses or nasal cavity with calcification within it, which may not appear solid or dense and is separate from the walls of the sinus.     

鼻腔、副鼻窦原发性肿瘤70例CT分析

本文回顾分析了70例经手术病理证实的鼻腔、副鼻窦原发性良恶性肿瘤的临床和CT表现。讨论了良恶性肿瘤的鉴别诊断,不典型的CT表现及CT的检查价值,认为CT检查可做为鼻腔、副鼻窦肿瘤的首选方法。     

Radiological follow-up of inverted papilloma

The aim of this study was to describe cross-sectional imaging features of recurrent papilloma of the nasal fossa and paranasal sinuses and to evaluate the role of MR and CT in the postoperative follow-up of this lesion. Magnetic resonance imaging and CT of ten patients who presented recurrence of inverted papilloma were reviewed and correlated to initial imaging, endoscopy, and surgical reports. Imaging patterns of recurrent inverted papilloma are identical to those of initial tumors and recurrence location is closely related to the site of the former lesion. Magnetic resonance is more efficient than CT for the diagnosis and evaluation of extensions. Magnetic resonance supplies the deficiencies of endoscopy in case of extensions to the frontal sinus or the lateral recess of the antrum, especially if mucosal hyperplasia or sinusitis is associated. Magnetic resonance imaging is the first imaging modality to perform in the follow-up after removal of inverted papilloma. Received: 28 April 1999; Revised: 18 November 1999; Accepted: 19 November 1999     

鼻腔鼻窦少见肿瘤的CT表现

目的　探讨鼻腔鼻窦少见肿瘤的CT影像特征及鉴别诊断。方法　回顾性分析 2 6例鼻腔鼻窦少见肿瘤的CT表现 ,并与同期 9例鼻腔鼻窦癌相比较。结果　所有病例均呈实质性肿块 ,2 7 3 5例伴有单侧或双侧鼻窦炎。良性 11例 ,除血管瘤有强化及脑膜瘤钙化特征外 ,余具备良性肿瘤的一般特点 ,各类型不易区分 ;恶性 15例 ,恶性黑色素瘤体积小 ,恶性肉芽肿呈弥漫浸润 ,其余同一般恶性表现。结论　鼻腔鼻窦少见肿瘤多数类型较相同部位常见肿瘤无特征性差异 ;良恶性主要鉴别点为病变外形 ,骨质改变及病变范围 ,诊断需结合临床病理。增强扫描有一定价值     

Computed tomography of osteogenic sarcoma of nasal cavity and paranasal sinuses

Computed tomography was performed in four patients with osteogenic sarcoma of the nasal cavity and paranasal sinuses. In all cases CT demonstrated an abnormal soft tissue mass with associated aggressive bony destruction. In only one case were areas of calcification and new bone formation identified, allowing a preoperative diagnosis. The CT appearance of these four patients plus an additional four cases previously reported in the literature are reviewed.