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目的:分析中耳腺瘤的CT、MRI特征,结合临床表现探讨影像学检查对中耳腺瘤术前诊断及鉴别诊断的意义。方法:回顾2004-2014年在首都医科大学附属北京同仁医院耳科接受手术治疗并经病理检查证实的8例中耳腺瘤患者的完整病例资料,包括临床表现与体征、纯音测听、颞骨CT与MRI检查结果。结果:8例患者有听力下降伴耳鸣或耳闷,2例伴有耳痛,其中1例伴周围性面瘫。5例鼓膜膨隆,2例肿物穿透鼓膜生长至外耳道,1例鼓膜正常。纯音测听4例表现为传导聋,4例表现为混合聋。颞骨CT检查7例可见鼓室、乳突软组织影,均包埋听骨链,骨质无明显破坏,其中2例鼓室软组织影向外耳道突出,1例软组织影局限于中鼓室。内耳MRI检查5例表现为鼓室等T1等T2信号影,增强后明显强化;乳突腔长T1或等T1、长T2信号影,无强化,提示阻塞性炎症。结论:中耳腺瘤的颞骨CT特征为鼓室软组织影不伴骨质异常,内耳MRI特征为鼓室等T1等T2信号、明显强化结节影。结合中耳腺瘤的临床特点,有助于该病的术前诊断。
Objective: To analyze CT and MRI features of middle ear adenoma and to explore the significance of imaging examination in preoperative diagnosis and differential diagnosis of middle ear adenoma in combination with clinical manifestations. Methods: A retrospective review of the data of 8 cases of middle-ear adenoma confirmed by pathology in Beijing Tongren Hospital affiliated to Capital Medical University from 2004 to 2014, including clinical manifestations and signs, pure tone audiometry, temporal bone CT And MRI examination results. Results: Eight patients had hearing loss accompanied by tinnitus or ear bothersome, 2 patients with earache, including 1 with peripheral facial paralysis. 5 cases of tympanic membrane bulging, 2 cases of tumor penetrating tympanic membrane to the external auditory canal, 1 case of normal tympanic membrane. 4 cases of pure tone audiometry showed conduction deafness, 4 cases showed mixed deafness. Temporal bone CT examination in 7 cases can be seen tympanic and papillary soft tissue shadow, were buried ossicular chain, no significant destruction of bone, including 2 cases of tympanic soft tissue shadow prominent to the external auditory canal, 1 case of soft tissue shadow confined to the tympanic cavity. Internal auditory meatus in 5 cases showed tympanic T1 and other T2 signals, enhanced significantly enhanced; mastoid T1 or T1, T2 signal, without enhancement, suggesting obstructive inflammation. CONCLUSIONS: Temporal bone CT features of middle ear adenoma are T2-weighted images of tympanic soft tissue without bone anomalies and MRI of the inner ear, such as tympanic T1, which significantly enhance nodules. Combined with the clinical features of the middle ear adenoma, contribute to the preoperative diagnosis of the disease.