Ergene E, Rupp F W, Qualls C R, Ford C C
Department of Neurology, University of New Mexico School of Medicine, 915 Camino de Salud NE, Albuquerque, New Mexico 87131-5281, USA.
J Neuroimaging. 2000 Oct;10(4):209-15. doi: 10.1111/jon2000104209.
The authors compared the frequency of paranasal sinus inflammatory changes (SIC) on brain magnetic resonance imaging (MRI) obtained from 23 patients with new onset acute optic neuritis (ON) and 48 control patients who underwent outpatient MRI of the brain for reasons other than ON. The authors found a higher frequency of paranasal SIC in patients with ON (83%) than in controls (54%) (p = 0.02). The distribution of paranasal SIC (in ON and in controls) was maxillary (83% and 52%), ethmoid (4% and 2%), frontal (9% and 14%), and sphenoid (4% and 10%). Frequency of the maxillary SIC was significantly higher (p = 0.02) in patients with ON than in controls. Further evaluation of maxillary paranasal SIC with a grading system showed the presence of thickened mucosal lining of the sinuses (grade I) in 17% (ON) and 23% (controls), mucous retention cysts within the sinuses (grade II) in 48% (ON) and 25% (controls), and severe mucosal thickening with complete or near-complete filling of the sinus or an air-fluid level within the sinus (grade III) in 17% (ON) and 4% (controls). Combined frequency of grade II and grade III SIC was significantly higher in the ON group than in controls (p = 0.005), as was the frequency of grade III SIC alone (p = 0.02). Grade I SIC did not significantly differ between the groups. There was a trend (p = 0.09) toward a higher prevalence of bilateral sinus inflammatory changes in patients with bilateral ON. These findings suggest that ON may be associated with sinus inflammatory changes.
作者比较了23例新发急性视神经炎（ON）患者和48例因非ON原因接受脑部门诊磁共振成像（MRI）检查的对照患者脑部MRI上鼻窦炎性改变（SIC）的频率。作者发现，ON患者中鼻窦SIC的频率（83%）高于对照组（54%）（p = 0.02）。鼻窦SIC（在ON患者和对照组中）的分布情况为：上颌窦（83%和52%）、筛窦（4%和2%）、额窦（9%和14%）和蝶窦（4%和10%）。ON患者上颌窦SIC的频率显著高于对照组（p = 0.02）。采用分级系统对上颌窦SIC进行进一步评估显示，鼻窦黏膜增厚（I级）在ON患者中占17%，在对照组中占23%；鼻窦内黏液潴留囊肿（II级）在ON患者中占48%，在对照组中占25%；鼻窦黏膜严重增厚伴鼻窦完全或近乎完全充盈或鼻窦内出现气液平面（III级）在ON患者中占17%，在对照组中占4%。II级和III级SIC的合并频率在ON组显著高于对照组（p = 0.005），单独的III级SIC频率也是如此（p = 0.02）。I级SIC在两组之间无显著差异。双侧ON患者双侧鼻窦炎性改变的患病率有升高趋势（p = 0.09）。这些发现表明，ON可能与鼻窦炎性改变有关。
