鼻腔鼻窦内翻性乳头状瘤的CT诊断

目的:探讨鼻腔鼻窦内翻性乳头状瘤(SNIP)的CT特点及诊断价值。方法:回顾性分析48例经手术病理诊断为SNIP的临床手术病理及CT资料,结合文献讨论。结果:48例SNIP中,男性居多(62.5%),鼻塞、流涕为主要临床症状(100%),50%的患者涕中带血,31.25%的患者嗅觉减退,18.75%的患者嗅觉丧失,12.5%的患者6年内复发。SNIP主要为单侧发病(93.75%),病变最易累及同侧上颌窦(55.56%)。CT平扫SNIP均呈鼻腔鼻窦内软组织密度肿块,CT值(45.61±1.02)HU。受累窦腔内肿块完全充填者21例(43.75%),未完全充满窦腔者22例(45.83%),受累窦腔呈轻度膨胀性改变21例(43.75%),窦壁及鼻甲骨质吸收或破坏42例(87.5%),受累窦腔较健侧缩小7例(14.58%),局限于鼻腔呈息肉样改变2例(4.17%)。结论:SNIP具有一定的CT特点,术前CT检查对SNIP累及的部位、范围等可准确确定,可为手术治疗提供重要的参考依据。 

CT Diagnosis of Sinonasal Inverted Papilloma

Object: To study the value of CT in diagnosis of sinonasal inverted papilloma (SNIP). Methods: 48 cases of SNIP proved by operation and pathology were reviewed retrospectively. Results: Among 48 cases of SNIP, male patients accounted for the majority (62.5%). Rhinobyon and rhinorrhoea were main clinical symptoms (100%), 50% of the patients were accompanied with blood in rhinorrhoea, 31.25% presented hyposmia, 18.75% presented anosmia, 12.5% had a relapse with postoperative 6 years. Among 48 cases, there were 45 cases of unilateral lesions (93.75%). Lesions were most frequently involved ipsilateral maxillary sinus (55.56%). CT plain scan of all SNIP cases showed nasal sinuses soft tissue density mass, and CT value was (45.61~1.02) HU. There were 21 cases of lumps completely filling with involved sinus cavity (43.75%), and 22 cases of lumps incompletely filling with involved sinus cavity (45.83%). In addition, 21 cases of involved sinus cavities presented mild expansion changes (43.75%), 42 cases presented bone absorption or damage of sinus wall and turbinate (87.5%), 7 cases presented affected sinus cavity smaller than the normal-side sinus cavity (14.58%), and 2 cases were limited to nasal polyploidy changes (4.17%). Conclusions: SNIP has a certain CT characteristics, and preoperative CT examination can accurately determine SNIP-involved position and range and can provide an important reference basis for surgical treatment.