Henninger Wolfgang, Frame E Mairi, Willmann Michael, Simhofer Hubert, Malleczek Dieter, Kneissl Sibylle M, Mayrhofer Elisabeth
Clinic of Radiology, University of Veterinary Medicine, Vienna, A-1210 Vienna, Veterinärplatz 1, Austria.
Vet Radiol Ultrasound. 2003 May-Jun;44(3):269-76. doi: 10.1111/j.1740-8261.2003.tb00454.x.
Sinusitis is a common disorder in horses and may result from trauma, dental diseases, or space-occupying lesions. Radiography can only provide a limited amount of information. Computed tomography (CT) has been documented as an alternative imaging method. Eighteen horses (mostly Warmblood) with signs of chronic sinusitis were examined preoperatively with CT to assist in diagnosis of the underlying cause. There was a group of common CT features in horses with dental disease and sinusitis. The first molar was the most frequently affected maxillary cheek tooth. Hypoattenuation of the cementum, destruction of the enamel, and filling of the infundibular cavity with gas were the most frequent CT findings associated with caries. Gas bubbles within the bulging root area or fragmentation of the root in combination with swelling of the adjacent sinus lining were the most important CT features of dental decay. CT findings associated with sinusitis included excessive thickening of the respiratory epithelium in the rostral maxillary sinus; the caudal maxillary sinus was less often involved. The infraorbital canal, the nasomaxillary duct, and the frontomaxillary aperture were usually involved. The maxillary bone, however, especially the facial crest, was involved in nearly every horse, being characterized by endosteal sclerosis, thickening, periosteal reaction, and deformation leading to facial swelling in chronic infections. CT images allowed identification of involvement of individual teeth more clearly to reveal the diseased one for treatment. Three-dimensional imaging allowed improved understanding of the extent and severity of the pathologic change.
鼻窦炎是马匹常见的疾病，可能由外伤、牙齿疾病或占位性病变引起。X线摄影只能提供有限的信息。计算机断层扫描（CT）已被证明是一种替代成像方法。对18匹有慢性鼻窦炎症状的马（大多为温血马）进行术前CT检查，以协助诊断潜在病因。患有牙齿疾病和鼻窦炎的马匹有一组常见的CT特征。第一磨牙是上颌颊齿中最常受影响的牙齿。牙骨质低密度、牙釉质破坏以及漏斗状腔隙内气体充填是与龋齿相关的最常见CT表现。牙根膨大区内的气泡或牙根断裂伴相邻鼻窦黏膜肿胀是龋齿最重要的CT特征。与鼻窦炎相关的CT表现包括上颌窦前部呼吸上皮过度增厚；上颌窦后部较少受累。眶下管、鼻上颌管和额上颌孔通常受累。然而，几乎每匹马的上颌骨，尤其是面嵴，都有受累，其特征是骨内膜硬化、增厚、骨膜反应和变形，导致慢性感染时面部肿胀。CT图像能更清晰地识别单个牙齿的受累情况，以揭示患病牙齿以便治疗。三维成像有助于更好地了解病理变化的范围和严重程度。
