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目的探讨CT及MRI在鼻腔鼻窦内翻性乳头状瘤(sinoasal and nasal inverted papilloma,SNIP)临床诊断中的应用价值。方法回顾性分析我科2012年6月至2015年11月期间行手术病理确诊的SNIP患者100例,术前均有CT及MRI检查,比较CT、MRI、CT结合MRI诊断与病理诊断的符合率,并分析CT、MRI的影像诊断特点。结果 100例SNIP中起源于上颌窦27例,筛窦22例,额窦16例,鼻甲15例,窦口鼻道复合体8例,蝶窦7例,不能确认起源5例;CT与MRI诊断的分期符合率为98.0%,明显高于单独CT或MRI的诊断符合率94.0%、96.0%;CT表现:单侧鼻腔鼻窦软组织病变,骨炎症出现率为63.0%(63/100),与起源部位一致率64.6%(42/65),9例出现眶纸板或前颅底骨质破坏,与恶变有关,MRI表现:97例出现脑回征,86例准确预测起源部位(准确率86.0%)。结论 CT联合MRI检查可全面显示SNIP的范围及其与周围软组织的界线,有助于术前肿瘤临床分期以及肿瘤起源的准确评估,从而更有利于实现早期诊断、早期治疗。
Objective To investigate the clinical value of CT and MRI in the diagnosis of nasal inverted papilloma (SNIP). Methods A retrospective analysis of 100 cases of SNIP patients diagnosed by pathology in our department between June 2012 and November 2015 was performed CT and MRI before operation. The coincidence rate of CT, MRI and CT with MRI diagnosis and pathological diagnosis was compared , And analysis of CT, MRI imaging diagnostic features. Results The origin of 100 cases of SNIP in 27 cases of maxillary sinus, 22 cases of ethmoid sinus, frontal sinus in 16 cases, 15 cases of nasal cavity, sinus ostium complex in 8 cases, sphenoid sinus in 7 cases, can not confirm the origin of 5 cases; CT and MRI diagnosis The coincidence rate of staging was 98.0%, which was significantly higher than that of CT or MRI (94.0%, 96.0%). The CT findings were unilateral sinonasal soft tissue lesions and bone inflammation (63.0%, 63/100) (42/65), 9 cases of orbital bone or anterior skull bone destruction, and malignant transformation, MRI manifestations: 97 cases of brain recurred, 86 cases of accurate prediction of the origin of the site (86.0% accuracy rate) . Conclusion CT combined with MRI examination can fully display the range of SNIP and its border with the surrounding soft tissue, which helps the clinical staging of tumor and the accurate assessment of tumor origin, which is more conducive to early diagnosis and early treatment.