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目的 探讨慢性中耳炎的HRCT特征、诊断及鉴别诊断。方法 回顾性分析 10 5例慢性中耳炎患者术前临床和HRCT检查资料 ,并与手术病理结果对照。结果 3 6例胆脂瘤型中耳炎HRCT表现为鼓室或 /及鼓窦内团块状软组织影和骨质改变 ,包括听骨硬化、移位、破坏 ,盾板破坏及中耳腔扩大 ,有的还伴有乙状窦、天盖、水平半规管的破坏。 69例渗出肉芽型中耳炎HRCT表现多呈斑片状、条索状或网状软组织影 ,部分可见液平 ,听骨移位及破坏较轻。结论 依据中耳腔内软组织影的分布、形态及骨质改变等特点 ,大多数慢性中耳炎可籍HRCT做出诊断或鉴别诊断。
Objective To investigate the characteristics, diagnosis and differential diagnosis of chronic otitis media. Methods A retrospective analysis of 105 cases of chronic otitis media in patients with preoperative clinical and HRCT examination data and surgical pathology results. Results HRCT of 36 cases of otitis media with cholesteatoma was manifested as bulky soft tissue and intramuscular changes in the tympanic cavity or / and the sinuses, including atherosclerosis, displacement and destruction, destruction of the shield plate and expansion of the middle ear cavity, and some Also associated with sigmoid sinus, canopy, horizontal semicircular canal destruction. 69 cases of exudative granulomatous otitis media HRCT showed mostly patchy, cord-like or reticular soft tissue shadow, the level of some can be seen, the shift and dislocation of the ossicles lighter. Conclusion According to the distribution of soft tissue shadow in the middle ear cavity, the morphology and bone changes, most chronic otitis media can be diagnosed or differentiated by HRCT.