Lenglinger F X, Krennmair G, Müller-Schelken H, Artmann W
Department of Radiology, Allgemeines Krankenhaus Wels der Barmherzigen Schwestern vom Heiligen Kreuz, Austria.
Eur Radiol. 1996;6(3):375-9. doi: 10.1007/BF00180617.
The purpose of this study was to investigate by CT the origin of radiodense maxillary sinus concretions and whether CT densitometry is effective in the prediction of maxillary sinus aspergillosis and in the differentiation of the origin of these concretions. In a prospective study in 21 patients with radiodense maxillary sinus concretions detected by radiography, a preoperative CT study of the paranasal sinuses and the concretions was undertaken. Additional scans of the upper alveolar ridge were also performed. Radiological findings were compared with clinical symptoms and with CT findings, especially CT densitometry of the sinus concretions and dental root-filling material. All patients underwent a functional Caldwell-Luc operation; histological and microbiological examinations were performed. Fifteen of the 21 patients (71.4%) with radiodense concretions had a histological and microbiological diagnosis of sinus aspergillosis. The sinus concretions had CT densities higher than 2000 HU (Hounsfield units) in 15 patients and lower than 2000 HU in 6. fourteen of 15 patients (93.3%) with concretions having CT densities higher than 2000 HU had a postoperative diagnosis of maxillary sinus aspergillosis. The mean CT density of the sinus concretions in patients with maxillary sinus aspergillosis was 2868 HU (range 1870-3070 HU), and in patients without aspergillosis was 778 HU (range 228-2644 HU). The mean CT density of the dental root-filling material was 2866 HU (range 2156-3070 HU). Paranasal sinus CT with CT densitometry of a sinus concretion has a higher accuracy than standard radiography and clinical findings in the prediction of maxillary sinus aspergillosis (93.3% vs 71.4%). CT densitometry helps to confirm the dental origin of maxillary sinus concretions and to explain a possible dental pathogenesis of maxillary sinus aspergillosis.
本研究的目的是通过CT研究上颌窦致密性结石的起源，以及CT密度测定法在上颌窦曲霉菌病预测和这些结石起源鉴别方面是否有效。在一项针对21例经X线检查发现上颌窦致密性结石患者的前瞻性研究中，对鼻窦和结石进行了术前CT检查。还对上颌牙槽嵴进行了额外扫描。将放射学结果与临床症状以及CT结果进行比较，尤其是鼻窦结石和牙根充填材料的CT密度测定结果。所有患者均接受了功能性柯德威尔-卢氏手术；进行了组织学和微生物学检查。21例上颌窦致密性结石患者中有15例（71.4%）经组织学和微生物学诊断为鼻窦曲霉菌病。15例患者的鼻窦结石CT密度高于2000 HU（亨氏单位），6例低于2000 HU。15例结石CT密度高于2000 HU的患者中有14例（93.3%）术后诊断为上颌窦曲霉菌病。上颌窦曲霉菌病患者鼻窦结石的平均CT密度为2868 HU（范围1870 - 3070 HU），无曲霉菌病患者为778 HU（范围228 - 2644 HU）。牙根充填材料的平均CT密度为2866 HU（范围2156 - 3070 HU）。鼻窦结石CT密度测定的鼻窦CT在预测上颌窦曲霉菌病方面比标准X线检查和临床检查具有更高的准确性（93.3%对71.4%）。CT密度测定有助于确认上颌窦结石的牙源性，并解释上颌窦曲霉菌病可能的牙源性发病机制。
