鼻息肉患者鼻腔淋巴系统核素显影的初步研究

目的 探讨鼻腔黏膜淋巴引流障碍在鼻息肉患者鼻黏膜中的表现.方法 应用核素显影技术对25例鼻息肉患者(试验组,又分为Malm-1、Malm-2、Malm-3级3个亚组)和需行前哨淋巴结核素检查且经鼻内镜检查鼻腔结构正常的6例甲状腺腺癌、喉癌等患者(对照组)的鼻腔黏膜特定部位进行核素注射,通过影像结果分析鼻腔黏膜淋巴引流状况.结果 试验组及对照组注射部位均未见到明显的淋巴显影及引流征象,但试验组注射点周围存在显影剂滞留现象.试验组、对照组感兴趣区(region of interest,ROI)内放射性计数比值((x)±s,以下同)分别为29.33 ±6.34、20.66 ±1.89,差异有统计学意义(t=3.275,P＜0.05).试验组中Malm-1、Malta-2、Malm-3级3个亚组ROI内放射性计数比值分别为24.40 ±3.19、29.31±3.39、39.21±3.15,3个亚组比较,差异有统计学意义(F=38.980,P＜0.05).结论 鼻息肉患者鼻黏膜淋巴引流存在功能紊乱.

Abstract：

Objective To explore the role of nasal mucosal lymphatic drainage in the pathogenesis of nasal polyps.Methods There were 25 cases in the experimental group who had nasal polyps ( which was further divided into Malm-1,Malm-2,Malm-3 level 3 subgroups)and 6 cases in the control group,including thyroid cancer and laryngeal cancer patients who had normal nasal structure.The nasal polyps in the experimental group and the middle turbinate in the control group were injected with a radionuclide and a radionuclide imaging technique was used to image the nasal mucosal lymphatics.The lymphatic drainage status of the nasal mucosa through the imaging results was analysed.Results The T/NT ratio ( radioactivity counting) of the region of interest( ROI) was 20.66 ± 1.89 in the control group and 29.33 ± 6.34 in the experimental group.The difference was significant (t =3.275 ,P ＜0.05 ) .The T/NT ratio of the ROI was 24.40 ±3.19 in the Malm-1 level group,29.31 ± 3.39 in the Malm-2 level group,39.21 ± 3.15 in the Malm-3 level group.The differences of qualitative analysis were significant ( F = 38.980,P ＜0.05 ) .The quantitative analysis showed that at the injection site,signs of lymphatic development and drainage were not found in the control group or experimental group,but the phenomenon of contrast media retention existed at the injection site in the experimental group.Conclusion Lymphatic drainage dysfunction exists in patients with nasal polyps,and it may play a role in the pathogenesis of nasal polyps.

A preliminary study of radionuclide imaging of the nasal lymphatic system in nasal polyps

Objective To explore the role of nasal mucosal lymphatic drainage in the pathogenesis of nasal polyps.Methods There were 25 cases in the experimental group who had nasal polyps ( which was further divided into Malm-1,Malm-2,Malm-3 level 3 subgroups)and 6 cases in the control group,including thyroid cancer and laryngeal cancer patients who had normal nasal structure.The nasal polyps in the experimental group and the middle turbinate in the control group were injected with a radionuclide and a radionuclide imaging technique was used to image the nasal mucosal lymphatics.The lymphatic drainage status of the nasal mucosa through the imaging results was analysed.Results The T/NT ratio ( radioactivity counting) of the region of interest( ROI) was 20.66 ± 1.89 in the control group and 29.33 ± 6.34 in the experimental group.The difference was significant (t =3.275 ,P ＜0.05 ) .The T/NT ratio of the ROI was 24.40 ±3.19 in the Malm-1 level group,29.31 ± 3.39 in the Malm-2 level group,39.21 ± 3.15 in the Malm-3 level group.The differences of qualitative analysis were significant ( F = 38.980,P ＜0.05 ) .The quantitative analysis showed that at the injection site,signs of lymphatic development and drainage were not found in the control group or experimental group,but the phenomenon of contrast media retention existed at the injection site in the experimental group.Conclusion Lymphatic drainage dysfunction exists in patients with nasal polyps,and it may play a role in the pathogenesis of nasal polyps.