Dong Yi, Zhou Bing, Wang Cheng-shuo, Huang Qian, Cui Shun-jiu, Li Yun-chuan, Wang Xin-yan
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education (Capital Medical University) , Beijing 100730, China.
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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013 Nov;48(11):895-900.
To study the CT and MRI findings of lesions in unilateral maxillary sinus, and to compare the effect of CT and MRI in the differential diagnosis of lesions in unilateral maxillary sinus.
Retrospective analysis of CT and contract-enhanced MRI imaging data from 34 patients with lesions in unilateral maxillary sinus which were diagnosed by endoscopic sinus surgery and postoperative pathology. The CT and contract-enhanced MRI's value in the differential diagnosis in lesions in unilateral maxillary sinus was analysed.
All 34 patients had unilateral maxillary sinus lesions. On CT: soft tissue density shadow in the unilateral maxillary sinus was found in all 34 cases. Five cases showed spot high density with thickening bone in the maxillary sinus wall. Eleven cases showed expansion of the opening of maxillary sinuses. Two cases showed broken lateral wall of nasal cavity . One case showed soft tissue density shadow in the maxillary sinus with curve edge with high density shadow which had a tooth shadow in it. Other 14 cases showed only soft density shadow in the maxillary sinuses. On MRI: all 34 cases revealed lower signals on T1WI compared to gray matter. Little loss signal were found in the inner of the maxillary sinus fungal balls on T1WI. Enhanced MR imaging showed no enhanced in nasal sinusitis, sinus cysts and polyp of posterior naris. In homogenous enhancing and "the cerebral convolution sign" were found in the hemorrhagic and necrotic nasal polyp, the nasal inverted papilloma and the malignant tumor cases. Higher signals were seen in the nasal sinusitis, fungal balls and the polyp of posterior naris cases on T2WI. In homogenous signal with different levels were found in the hemorrhagic and necrotic nasal polyp, the nasal inverted papilloma and the malignant tumor cases on T2WI.
CT and MRI examination are important in the diagnosis of the unilateral maxillary sinus lesions. Both CT and MRI had more differential diagnostic value in the unilateral maxillary sinus lesions than only CT used.
研究单侧上颌窦病变的CT及MRI表现,比较CT与MRI在单侧上颌窦病变鉴别诊断中的作用。
回顾性分析34例经鼻内镜鼻窦手术及术后病理确诊的单侧上颌窦病变患者的CT及增强MRI影像资料,分析CT及增强MRI在单侧上颌窦病变鉴别诊断中的价值。
34例患者均有单侧上颌窦病变。CT表现:34例均见单侧上颌窦软组织密度影,5例见上颌窦壁斑点状高密度影伴骨质增厚,11例见上颌窦开口扩大,2例见鼻腔外侧壁骨质连续性中断,1例见上颌窦内软组织密度影呈弧形边缘伴高密度影内有牙齿影,其余14例仅见上颌窦内软组织密度影。MRI表现:34例T1WI均呈低于灰质信号,上颌窦真菌球内部T1WI呈少许低信号。增强扫描显示鼻窦炎、鼻窦囊肿及后鼻孔息肉无强化,出血坏死性鼻息肉、鼻腔内翻性乳头状瘤及恶性肿瘤呈均匀强化及“脑回征”。鼻窦炎、真菌球及后鼻孔息肉T2WI呈高信号,出血坏死性鼻息肉、鼻腔内翻性乳头状瘤及恶性肿瘤T2WI呈不均匀信号。
CT及MRI检查对单侧上颌窦病变的诊断具有重要意义,两者联合应用对单侧上颌窦病变的鉴别诊断价值优于单纯CT检查。