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目的 探讨CT在中耳疾病诊断中的应用及其价值。材料与方法 搜集本院经手术病理证实的中耳疾病 43例 46耳 :慢性化脓性中耳炎 3 6耳 ,其中单纯型 5耳 ,骨疡型 (肉芽肿型 ) 10耳 ,胆脂瘤型 2 1耳 (其中 1耳为乳突根治术后复发 )。中耳癌 4耳 ,中耳先天畸形 6耳。所有病例术前均行双侧乳突Mayer’s位和Schuller’s位摄片及螺旋CT轴位、冠状靶放大扫描。CT、平片所见与手术、病理对照。结果 3 6耳慢性化脓性中耳炎中 ,单纯型 5耳和骨疡型 10耳乳突平片均见乳突密度增高 ,2 1耳胆脂瘤型中乳突平片 10耳见明确的骨质破坏 ,诊断为胆脂瘤型 ,5耳见鼓窦入口略大可疑胆脂瘤形成 ,6耳胆脂瘤漏诊。 4耳中耳癌中平片仅 2耳见明确的骨质破坏。 6耳先天畸形平片仅反映乳突气化情况。而CT不但清楚地显示了耳内外解剖结构 ,而且显示的病变及其范围和浸润的程度均与手术所见一致。此外 ,还发现 3耳胆脂瘤型慢性化脓性中耳炎合并脑脓肿 ,1耳中耳癌浸润颞叶。结论 乳突平片已不能适应现代耳科显微手术的发展 ,不能满足临床的需要 ,螺旋CT明显优于平片 ,在中耳疾病诊断中起重要作用
Objective To explore the application of CT in the diagnosis of middle ear diseases and its value. Materials and Methods Forty-six cases of middle ear disease confirmed by surgery and pathology were collected from 46 patients with chronic suppurative otitis media, including 6 ears of simple suppurative otitis media, 5 ears of simple type, 10 cases of osteoporosis (granulomatous type) and 21 cases of cholesteatoma Ear (of which 1 ear is mastoid recurrence after radical surgery). Middle ear carcinoma 4 ears, middle ear congenital malformations 6 ears. All patients underwent preoperative bilateral mastoid Mayer’s and Schuller’s radiographs and axial CT scan, coronary target enlargement scan. CT, plain film and surgery, pathology control. Results In 36 cases of chronic otitis media with suppurative otitis media, the density of papillae was increased in the simple ears of 5 ears and in the bone-ulna in 10 ears, and the clear bone was found in 10 ears of 21 ear cholesteatoma Vandalism, the diagnosis of cholesteatoma, 5 see the drum sinus entrance slightly suspicious cholesteatoma formation, 6 ear cholesteatoma missed diagnosis. 4 ears in plain film only 2 ears to see a clear bone destruction. 6 ears congenital malformations plain film only reflects the mastoid gasification situation. CT not only clearly shows the anatomy inside and outside the ear, but also shows the extent of lesions and extent of infiltration and surgical findings are consistent. In addition, 3 ear cholesteatoma chronic suppurative otitis media was found with cerebral abscess, 1 ear and middle ear carcinoma infiltrating the temporal lobe. Conclusion The mastoid plain can not adapt to the development of modern otological microsurgery and can not meet the clinical needs. Spiral CT is superior to plain film and plays an important role in the diagnosis of middle ear disease