山东大学耳鼻喉眼学报 ›› 2021, Vol. 35 ›› Issue (5): 32-35.doi: 10.6040/j.issn.1673-3770.0.2021.041
秦贺1,万宝刚2,王洪丽1,赵本绮3
QIN He1, WAN Baogang2, WANG Hongli1, ZHAO Benqi3
摘要: 目的 探讨CT检查在真菌球型鼻窦炎术前诊断中的临床意义。 方法 回顾性分析2019年1月~2020年12月术前CT检查判断为真菌球型鼻窦炎32例患者的病例资料,包括术前CT检查、术中所见和术后病理结果。所有患者入院后均行鼻窦CT平扫并重建,均行内镜鼻窦手术,术中观察鼻窦内黏膜肿胀、分泌物等情况,并与术前鼻窦CT影像学检查进行对比。 结果 30例患者术中检查和术后病理明确诊断为真菌性鼻窦炎,诊断准确率为93.7%。鼻窦CT检查可见鼻窦内钙化影27例;鼻窦内完全浑浊高密度影21例;部分浑浊且表面不规则的“土坷垃征”13例;鼻窦局部骨质增厚16例。另外2例患者术后病理诊断为上颌窦嗜酸细胞乳头状瘤1例、出血坏死性息肉1例。 结论 真菌球型鼻窦炎患者CT主要特征是鼻窦内软组织不均匀密度影,其内可见高密度钙化点;其次鼻窦内部分浑浊影,表面高低不平;骨质局部增生肥厚也是其体征性表现。单纯依靠CT检查结果诊断真菌球型鼻窦炎有误诊的可能。
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