-
摘要: 目的:探讨慢性鼻-鼻窦炎患者鼻窦骨质改变的特点,明确鼻窦骨质改变与鼻窦腔引流状态的关系。方法:慢性鼻-鼻窦炎患者210例,正常对照组40例,利用PHILIPS MxLiteView软件分析术前鼻窦CT,测量鼻窦骨质拟研究部位CT值;同时采用SPSS 13.0软件分析不同引流状态的鼻窦骨壁HU值的差异。结果:对于前组筛窦,软组织影组眶纸板HU值(203.82±34.80)明显高于正常对照组(14.12±13.05)和无软组织影组(16.00±12.04),均差异有统计学意义(P<0.05)。对于后组筛窦,软组织影组眶纸板HU值(209.41±45.31)明显高于正常对照组(15.13±11.15)和无软组织影组(20.41±15.31),差异有统计学意义(P<0.05)。对于额窦,软组织影组额窦后壁骨质HU值(1 161.8±65.75)高于正常对照组(551.00±59.60)和无软组织影组(641±68.40),差异有统计学意义(P<0.05)。结论:慢性鼻-鼻窦炎鼻窦骨质HU值在有软组织影的鼻窦,即存在黏膜顽固病变和(或)引流障碍的鼻窦,出现骨质信号的改变,提示鼻窦的引流障碍与鼻窦骨质HU值改变有关。该部位HU值的改变可能提示相应窦腔黏膜病变的不可逆,可能是判断是否需行鼻内镜手术的客观标志。Abstract: Objective: To correlate abnormal bone density of sinus wall with impaired drainage of sinus cavity.Method: A retrospective radiological study was conducted:pre-operative CT scans of 210 patients with chronic rhinosinusitis(CRS) and CT scans of 40 age-and gender-matched individuals(normal group) without sinonasal disease were reviewed. Opacification of the paranasal sinuses and the radiological density of sinus wall were evaluated and analyzed using PHILIPS MxLite View software.Result: The Hounsfield Units obtained from the lamina papyracea in opaque anterior ethmoid sinus and posterior ethomid sinus were statistically significantly higher than that of the no opacification population in AES and PES and that of the normal group. Secondly, the Hounsfield Units of posterior wall in the opaque frontal sinus in patients with CRS were statistically significantly higher than that of the no opacification CRS patient group and the normal group.Conclusion: Inflammatory bone density changes in CRS patients were observed in the opaque sinuses, and few were found in the sinuses that were not opaque sinuses, suggesting that osteitis mainly occurs in sinuses with drainage disorder or mucosa disease. These change implied that HU change might be a mark of intractable disease and surgery.
-
Key words:
- chronic rhinosinusitis /
- ostitis /
- radiology
-
[1] SETHI N. The significance of osteitis in rhinosinusitis[J].Eur Arch Otorhinolaryngol,2015,272:821-826.
[2] 唐凤珠,瞿申红,梁建平,等.慢性鼻-鼻窦炎筛窦骨质病理形态学改变及其相关因素分析[J]. 临床耳鼻咽喉头颈外科杂志,2011,25(23):1060-1063.
[3] LEUNG N, MAWBY T A, TURNER H, et al. Osteitis and chronic rhinosinusitis:a review of the current literature[J]. Eur Arch Otorhinolaryngol,2015,25:671-675.
[4] SIDDIQUI J, MILLARD R, EWEISS A Z, et al. Sinonasal bony changes in nasal polyposis:prevalence and relationship to disease severity[J]. J Laryngol Otol, 2013,127:755-759.
[5] GEORGALAS C. Osteitis and paranasal sinus inflammation:what we know and what we do not[J]. Curr Opin Otolaryngol Head Neck Surg, 2013,21:45-49.
[6] 成雷,黄振校,周兵,等.整体骨炎评分系统在慢性鼻-鼻窦炎中的临床应用及骨炎评估的意义[J]. 中华耳鼻咽喉头颈外科杂志, 2013,48(2):119-122.
[7] 成雷,黄振校,黄谦,等.影响慢性鼻-鼻窦炎骨炎的相关因素临床分析[J].中华耳鼻咽喉头颈外科杂志,2014,49(3):205-209.
[8] HUANG Z, HAJJIJ A, LI G, et al. Clinical predictors of neo-osteogenesis in patients with chronic rhinosinusitis[J]. Int Forum Allergy Rhinol, 2015,5:303-309.
[9] VIDELER W J, GEORGALAS C, MENGER D J, et al. Osteitic bone in recalcitrant chronic rhinosinusitis[J]. Rhinology, 2011,49:139-147.
[10] GEORGALAS C, VIDELER W, FRELING N, et al. Global osteitis scoring scale and chronic rhinosinusitis:a marker of revision surgery[J]. Clin Otolaryngol, 2010,35:455-461.
[11] LEE J T, KENNEDY D W, PALMER J N, et al. The incidence of concurrent osteitis in patients with chronic rhinosinusitis:a clinicopathological study[J]. Am J Rhinol,2006,20:278-282.
[12] EMRE I E, CELEBI I,ERCAN I.The radiologic evaluation of osteitis type and formation in chronic rhinosinusitis with and without nasal polyposis[J]. Am J Rhinol Allergy,2015,29:e201-e204.
[13] 林枫,周兵,成雷,等.整体骨炎评分与慢性鼻-鼻窦炎预后的相关性分析[J].中国耳鼻咽喉颅底外科杂志,2015,15(1):8-13.
[14] GUNEL C, YUKSELEN O O, BASAK H S,et al. Chronic rhinosinusitis; histopathologic study of osteitis in surgery cases[J]. B-ENT, 2015,11:135-139.
计量
- 文章访问数: 87
- PDF下载数: 55
- 施引文献: 0