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目的:探讨鼻腔鼻窦内翻性乳头状瘤(SNIP)的CT特点及诊断价值。方法:回顾性分析48例经手术病理诊断为SNIP的临床手术病理及CT资料,结合文献讨论。结果:48例SNIP中,男性居多(62.5%),鼻塞、流涕为主要临床症状(100%),50%的患者涕中带血,31.25%的患者嗅觉减退,18.75%的患者嗅觉丧失,12.5%的患者6年内复发。SNIP主要为单侧发病(93.75%),病变最易累及同侧上颌窦(55.56%)。CT平扫SNIP均呈鼻腔鼻窦内软组织密度肿块,CT值(45.61±1.02)HU。受累窦腔内肿块完全充填者21例(43.75%),未完全充满窦腔者22例(45.83%),受累窦腔呈轻度膨胀性改变21例(43.75%),窦壁及鼻甲骨质吸收或破坏42例(87.5%),受累窦腔较健侧缩小7例(14.58%),局限于鼻腔呈息肉样改变2例(4.17%)。结论:SNIP具有一定的CT特点,术前CT检查对SNIP累及的部位、范围等可准确确定,可为手术治疗提供重要的参考依据。
Objective: To investigate CT features and diagnostic value of inverted papilloma (SNIP) in nasal sinus. Methods: A retrospective analysis of 48 cases of pathological diagnosis of SNIP clinical pathology and CT data, combined with the literature discussion. Results: In 48 SNIP cases, 62.5% were male, nasal obstruction and runny nose were the main clinical symptoms (100%), 50% of the patients had bloody runny nose, 31.25% of the patients had olfactory dysfunction, 18.75% of the patients lost their sense of smell, 12.5% of patients relapse within 6 years. The incidence of SNIP was mainly unilateral (93.75%). The lesion most likely involved ipsilateral maxillary sinus (55.56%). CT scan SNIP were soft tissue density within the nasal sinus mass, CT value (45.61 ± 1.02) HU. Twenty-four cases (43.75%) were involved in sinus cavity filling, 22 cases (45.83%) did not fully fill the sinus cavity, 21 cases (43.75%) were affected by slight expansion of sinus cavity, 42 cases (87.5%) were absorbed or destroyed, 7 cases (14.58%) contracted to the contralateral side of the affected sinus, and 2 cases (4.17%) were limited to nasal polypoid changes. Conclusion: SNIP has certain CT features. The location and range of SNIP involved in preoperative CT examination can be accurately determined, which can provide an important reference for surgical treatment.