摘要
目的：探讨鼻窦冠状位CT在诊断和治疗鼻腔鼻窦恶性肿瘤中的价值。方法：回顾分析50例鼻腔鼻窦恶性肿瘤冠状位CT表现，根据鼻窦冠状位CT上显示的肿瘤侵犯范围制订治疗方案。结果：所有鼻腔鼻窦肿瘤均经鼻内镜下取病理确诊，其中鼻腔鼻窦鳞癌占30.0%（15/50），黑色素瘤占14.0%（7/50），腺样囊性癌占14.0%（7/50），嗅神经母细胞瘤占8.0%（4/50），淋巴瘤占14.0%（7/50），其他恶性肿瘤占20.0%（10/50）。鳞癌多侵犯上颌窦，占66.7%，鼻腔鼻窦黑色素瘤多发于鼻腔，侵犯筛窦达71.4%，嗅母细胞瘤多起源于鼻腔，侵犯筛窦达100.0%，鼻腔鼻窦淋巴瘤侵犯鼻腔双侧达28.6%，在各鼻窦均可有发生和侵犯。根据鼻窦冠状位CT病变范围选择术式，鼻内镜下切除肿瘤为30.0%（15/50）、鼻内镜下仅取病理为26.0%（13/50）、鼻内镜辅助经上颌窦手术为14.0%（7/50）、鼻内镜辅助鼻侧切20.0%（10/50）、上颌骨和或眶内容物手术分别为10.0%（5/50）。结论：鼻窦冠状位CT能清楚显示病变范围和累及部位，对于鼻腔鼻窦恶性肿瘤的诊断和选择治疗方案具有重要价值。
Abstract
Objective: To explore the value of CT findings in the diagnosis and management of sinonasal malignancies. Methods: Fifty cases of coronal CT findings in sino-nasal malignancies were analysed retrospectively, and treatment planning were made depending on the CT manifestations. Results: All of the tumors were diagnosed under endoscopy. The rates of squamous cell carcinoma, melanoma, adenoid cystic carcinoma, olfactory neuroblastoma, lymphoma, and other malignancies were 30.0%(15/50), 14.0%(7/50), 14.0%(7/50), 8.0%(4/50), 14.0%(7/50) and 20.0%(10/50), respectively in which 66.7% of the squamous cell carcinomas invaded maxillary sinus; Most of the melanoma originated from nasal cavity, 71.4% of which invaded ethmoid sinus; Most of the olfactory neuroblastoma originated from nasal cavity, 100.0% of which invaded ethmoid sinus; 28.6% of the lymphoma invaded both nasal cavities, also can occur in each of the sinuses. To select treatment method based on coronal CT findings: 30.0%(15/50) of the tumors were removed under endoscopy; 26.0%(13/50) of the patients were treated with chemotherapy or radiotherapy after diagnosed under endoscopy; 14.0%(7/50) of the tumors were removed with Caldwell-Luc operation combined with endoscopy; 20.0%(10/50) of the tumors were removed through nasal lateral approach combined with endoscopy; 10.0%(5/50) of the tumors needed to remove the partial or complete maxillary bone. Conclusion: The lesions and invasions of sino-nasal malignancies could be shown clearly on coronary CT of the nasal sinus, which has great value in the diagnosis and treatment selection of sino-nasal malignancies.
关键词
鼻窦肿瘤 /
体层摄影术 /
螺旋计算机
Key words
Paranasal sinus neoplasms /
Tomography /
spiral computed
白伟良;郑加贺;高 鑫;曹志伟;王振海.
鼻窦冠状位CT在诊断和治疗鼻腔鼻窦恶性肿瘤中的价值[J]. 中国临床医学影像杂志. 2011, 22(1): 10-12
BAI Wei-liang;ZHENG Jia-he;GAO Xin;CAO Zhi-wei;WANG Zhen-hai.
The value of coronal CT in the management of sinonasal malignancies[J]. Journal of China Clinic Medical Imaging. 2011, 22(1): 10-12
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