Vazquez Elida, Castellote Amparo, Piqueras Joaquim, Mauleon Susana, Creixell Santiago, Pumarola Felix, Figueras Concepción, Carreño Juan-Carlos, Lucaya Javier
Department of Pediatric Radiology, Area Materno-infantil, Hospital Universitario Vall d'Hebron, Psg Vall d'Hebron 119-129, E-08035 Barcelona, Spain.
Radiographics. 2003 Mar-Apr;23(2):359-72. doi: 10.1148/rg.232025076.
Acute mastoiditis is a serious complication of acute otitis media in children. Suppurative disease in the mastoid region occasionally spreads to the adjacent dura mater of the posterior and middle cranial fossae and the sigmoid sinus by means of thrombophlebitis, osseous erosion, or anatomic pathways, producing intracranial complications. Computed tomography (CT) should be performed early in the course of the disease to classify the mastoiditis as incipient or coalescent and to detect intracranial complications. On the basis of the clinical features and imaging findings, the disease is managed conservatively with intravenously administered antibiotics or treated with mastoidectomy and drainage plus antibiotic therapy. CT is therefore a decisive diagnostic tool in determining the type of therapy. In addition, magnetic resonance imaging is performed in patients with clinical symptoms or CT findings suggestive of intracranial complications because of its higher sensitivity for detection of extraaxial fluid collections and associated vascular problems.
急性乳突炎是儿童急性中耳炎的严重并发症。乳突区域的化脓性疾病偶尔会通过血栓性静脉炎、骨质侵蚀或解剖途径蔓延至后颅窝和中颅窝的邻近硬脑膜以及乙状窦，从而引发颅内并发症。在疾病早期应进行计算机断层扫描（CT），以将乳突炎分类为初期或融合期，并检测颅内并发症。根据临床特征和影像学表现，该病可通过静脉注射抗生素进行保守治疗，或采用乳突切除术及引流加抗生素治疗。因此，CT是确定治疗类型的决定性诊断工具。此外，对于有临床症状或CT表现提示颅内并发症的患者，应进行磁共振成像检查，因为其对检测轴外液体积聚和相关血管问题具有更高的敏感性。
