数字化摄影诊断腺样体肥大的价值(附86例分析)

目的:探讨鼻咽部侧位片对小儿腺样体肥大的诊断价值。方法:86例怀疑腺样体肥大患儿均摄鼻咽部侧位片,测量腺样体厚度、鼻咽腔宽度及后气道宽度(PAS),并计算腺样体指数A/N,以评估腺样体肥大程度。结果:A/N≤0.60者16例,0.61～0.70者14例,A/N≥0.71者56例;PAS≤5mm者36例;6～10mm者24例;≥10mm者26例。结论:X线鼻咽侧位片是诊断腺样体肥大简单、经济的一种重要检查方法。     

儿童腺样体肥大的X线诊断价值探讨

目的探讨鼻咽部侧位片对小儿腺样体肥大的诊断价值。方法76例怀疑腺样体肥大患儿均摄鼻咽部侧位片,测量腺样体厚度、鼻咽腔宽度及后气道宽度,并计算腺样体指数A／N,以评估腺样体肥大程度及后气道（PAS）宽度。结果大多数患儿腺样体有不同程度的增厚,13例患儿的A／N≤0．60,26例患儿的A／N在0．61～0．70之间,37例患儿的A／N≥10．71,同时PAS≤5mm的19例,最小直径约1．5mm;6～10mm的32例;≥10mm的25例。X线鼻咽部侧位片评估腺样体大小与鼻咽腔阻塞情况与鼻内镜及术中所见具有良好的一致性。结论X线鼻咽侧位片是诊断腺样体肥大简单、经济的一种重要检查方法。     

多层螺旋CT对儿童腺样体肥大的诊断价值

目的:探讨儿童腺样体肥大的多层螺旋CT表现及临床应用价值。方法:对41例患儿鼻咽部进行多层螺旋CT扫描,并进行矢状位重组,测量A/N值。结果:CT平扫所见鼻咽顶后壁软组织弥漫性增厚、鼻咽腔变窄,10例伴有鼻窦炎,6例伴有分泌性中耳炎。A/N值≤0.60者6例,介于0.60与0.70者15例,>0.70者20例。结论:多层螺旋CT检查儿童腺样体肥大有明显地优势,应作为腺样体肥大术前检查的首选方法。     

小儿腺样体肥大的X线表现(附136例总结及与132例正常对照)

目的:总结腺样体肥大的平片表现并介绍两种实用的测量方法.材料与方法:136例中,男88例,女48例.打鼾136例,张口呼吸126例.正常组132例.均常规摄吸气期鼻咽侧位平片.采用测A/n比值及平行曲线法阅片.结果:(1)正常组:A/n比值均≤0.66,鼻咽顶部,后壁软组织边缘不凸过(107例)或轻微凸入(25例)平行曲线;(2)异常组:鼻咽顶部,后壁软组织增厚,鼻咽腔变窄.A/n比值均＞0.70,其中128例＞0.80,鼻咽顶部、后壁软组织边缘均凸过平行曲线.结论:(1)摄吸气时的鼻咽侧位片是观察腺样体肥大的简单而准确的方法;(2)测定A/n比值用以观察腺样体的厚度,A/n比值≤0.66为正常,＞0.70为腺样体肥大,＞0.80者为腺样体显著肥大;(3)用划平行曲线法可勾画出腺样体的长径.     

多层螺旋CT在腺样体指数计算中的应用

腺样体指数即A／N值（儿童增殖腺一鼻咽腔比率测定），用米判断儿童的增殖腺属正常或病理性肥大。目前腺样体肥大的诊断标准国内尚不统一，耳鼻喉科和影像科专家意见也不尽一致，临床常根据症状、鼻咽镜检查及X线鼻咽侧位片测量等方法来确诊，但因鼻咽镜检查很难取得儿童的合作，而X线鼻咽侧位片又存在放大、重叠模糊定位点难找的缺陷，     

螺旋CT诊断儿童腺样体肥大的临床应用价值

目的:探讨螺旋CT在诊断儿童腺样体肥大的临床应用价值。方法:对68例患儿行鼻咽部行轴位CT扫描,层厚3.75mm,行0.625mm矢状面重建,观察腺样体形态并测量A/N比值。结果:68例均为腺样体弥漫性增大并向前不同程度突入后鼻孔,伴有双侧咽鼓管口淋巴组织增生及副鼻窦炎48例、中耳乳突炎25例、扁桃体肥大33例、鼻甲肥大57例。A/N≤0.61≥0.70者28例,A/N≥0.71者40例。结论:CT检查能全面准确显示腺样体肥大及阻塞鼻咽腔的程度,同时可以显示其并发症,CT检查是腺样体肥大术前检查的首选。     

鼻咽腺样体肥大的MR及CT诊断

目的:探讨腺样体肥大的CT及MR诊断价值及腺样体-鼻咽腔比率(A/N比值)对判断腺样体肥大程度的应用。方法:分析139例腺样体肥大患者的CT及MR表现,其中作CT矢状面图像重组或MR矢状面扫描的42例。重点观察病变部位的形态改变、邻近解剖关系及其并发症,并对其矢状面图像进行A/N比值测定。结果:腺样体肥大的CT及MR表现为鼻咽顶后壁中央弥漫性的软组织增生,呈团块状、山丘样突出或不规则增厚,咽旁间隙及颈动脉鞘区均无浸润表现,邻近骨质无异常改变。腺样体肥大指数A/N比值≥0.71有33例,0.70≥A/N比值≥0.61有7例,A/N比值≤0.60有2例。结论:CT和MR的横断面图像及矢状面图像的A/N比值的测定能准确地诊断腺样体肥大,明确并发症,并能准确量化肥大程度。     

儿童鼻咽部形态学的低剂量多层螺旋CT研究

目的利用低剂量多层螺旋CT多平面重建（MPR）技术探索儿童鼻咽部气道大小及鼻咽部顶后壁软组织厚度。方法收集2005年5月至2007年10月来我院检查鼻咽部儿童的CT扫描图像,选择其中符合条件的73例进行回顾性分析。为研究其鼻咽腔形态学特点,测量了儿童鼻咽顶后壁软组织厚度（A值）及鼻咽部矢状径（N值）,并计算二者比值。根据儿童年龄分为两组：A组1～7岁（n=42）,B组8～14岁（n=31）。结果所有儿童正常鼻咽部气道矢状位均呈镰刀形,周围脂肪间隙清晰,后缘光整连续。A组及B组鼻咽顶后壁软组织厚度（A值）均数大小分别为9．23±4．85mm和9．56±4．74mm;MN值范围两组分别为0．2～0．58和0．21～0．6;两组间没有统计学差异。结论低剂量多层螺旋CTMPR显示,1～14岁健康儿童鼻咽腔矢状位呈弓向上镰刀形,边缘光整,周围脂肪间隙清晰,A／N≤0．6。     

小儿鼾症鼻咽部侧位片105例X线分析

目的：通过对105例小儿鼾症鼻咽部侧位片的X线观察,探讨简便及适合基层医院的判断腺样体大小的检查方法。方法：105例小儿鼾症均照鼻咽部侧位片,采用A/N法测量及平行曲线法测量腺样体。结果：38例A/N≤0.6,59例A/N0.61~0.7,8例A/N≥0.71。结论：鼻咽部侧位片是了解腺样体大小的简便廉价有效的方法,可常规作为首选。     

儿童腺样体生理大小的多层螺旋CT研究

目的:探讨腺样体的多层螺旋CT(MSCT)测量方法,测定各年龄组儿童腺样体的生理大小.方法:回顾性分析因其它疾病而行鼻咽部CT扫描的56名儿童的CT横断图像,薄层重建后传送至工作站行多平面重组(MPR),于MPR正中矢状面测量腺样体的厚度(A)及鼻咽腔的宽度(N),以A/N比率反映腺样体的大小.56名儿童分三组分析:Ⅰ组1～3岁14人,Ⅱ组4～8岁19人,Ⅲ组9～14岁23人.结果:三组儿童腺样体厚度分别为8.78±1.19mm、10.19±1.18mm、9.32±1.21mm,Ⅰ、Ⅱ组腺样体厚度(A)有统计学意义(t=2.65, P<0.05);鼻咽腔宽度(N)分别为17.53±1.47mm、19.13±2.12mm、22.91±2.34mm,Ⅰ、Ⅲ组的鼻咽腔宽度具有显著差异性(t=3.25, P<0.01);三组儿童腺样体的A/N比率分别为0.49±0.07、0.51±0.08、0.46±0.05,各组儿童腺样体的A/N比率不具统计学意义(P>0.05).结论:了解儿童不同时期腺样体的生理大小,有助于临床判断腺样体有无肥大、肥大的程度.多层螺旋CT检查是儿童腺样体检查的首选.     

咽侧壁厚度在腺样体肥大CT诊断中的临床价值

目的 研究咽侧壁厚度在腺样体肥大CT诊断中的临床价值.方法 分析117例临床考虑腺样体肥大患者的CT表现,重点观察腺样体厚度、咽侧壁厚度,对其矢状面图像进行腺样体与鼻咽腔宽度(A/N)比值测定,探讨比值与咽侧壁厚度的相关性.结果 117例患者中,Ⅰ组A/N≥0.70,50例,咽侧壁厚度为(1.26±0.33)cm;Ⅱ组0.60   

青年男性鼻咽顶后壁MRI观察下腺样体的特征

 目的 探讨MRI观察下青年男性腺样体的特征。方法 回顾性分析2021-06至2022-05在武警浙江总队医院体检的1547名青年男性的头颅MRI图像,观察鼻咽顶后壁是否有腺样体及其MR信号特点、大体形态,测量腺样体最大厚度。结果 93.92%的青年男性鼻咽顶后壁可观察到残留的腺样体,平均最大厚度(7.66±2.80)mm,中位最大厚度7.32(5.58,9.25)mm,残留的腺样体最大厚度多为5～＜10 mm,占比66.62%。MRI图像上腺样体表现为鼻咽顶后壁软组织块影,呈长T₂信号,黏膜连续、完整,信号均匀,左右对称;邻近咽隐窝可因肿块受压变窄,咽旁间隙及周围骨质无异常改变,部分腺样体内可见囊肿。根据MRI正中矢状位的形态主要分为4种,镰刀形(241名)、新月形(601名)、D字形(501名)、纺锤形(110名),其中以新月形与D字形最为常见,纺锤形最大厚度最大,平均最大厚度为(12.53±3.03)mm。结论 多数青年男性鼻咽顶后壁可发现残留的腺样体,根据其对称性肿块、无邻近组织侵犯等特点,鉴别诊断不难。MRI正中矢状位能准确观察腺样体形态并精准测量其厚度,为临床提供了全面直观的影像学信息。     

鼻咽腺样体肥大的CT诊断

目的:探讨鼻咽腺样体肥大的CT表现及其鉴别诊断。方法:分析30例鼻咽腺样体肥大的CT表现,重点观察病变部位、咽旁软组织间隙、副鼻窦及乳突改变。结果:鼻咽顶壁和后壁软组织增厚,弥漫性向前下突出22例,呈山丘样突出8例,伴有双侧咽鼓管口淋巴组织增生及副鼻窦炎9例,伴中耳乳突炎5例,伴面骨发育障碍牙列不齐,堵塞后鼻孔2例。结论:鼻咽腺样体肥大不累及咽缝,无咽旁间隙侵犯。     

Nasopharyngeal lymphoid hyperplasia following treatment of patients with Hodgkin's disease

Nasopharyngeal tomography was performed in 64 patients following treatment of Hodgkin's disease. Symmetric soft tissue mass involving roof and lateral walls of the nasopharynx was revealed in 33 cases, of which 24 underwent biopsies from the nasopharynx. Histology of biopsy specimens detected characteristic lymphoid hyperplasia. Its frequency was found to be influenced by the mode of previous treatment. Its occurrence was more frequent amongst those having received total nodal irradiation (TNI) as to those with extended fields irradiation (EFI), the difference proved to be statistically significant. This finding supports our hypothesis that nasopharyngeal lymphoid hyperplasia is a compensatory mechanism evoked by damage of lymphoid tissue due to previous therapy. Nasopharyngeal biopsy or a close follow-up is proposed, depending on the shape of nasopharyngeal mass and the condition of cervical lymph node area.     

Nasopharyngeal tonsillolith: a report of 31 cases

OBJECTIVE: Nasopharyngeal tonsilloliths are less well known to radiologists than palatine tonsil lithiases. The possibility of routinely available fine slices during CT scans of the head and neck prompted a retrospective study on the causes and radiological signs and patterns of nasopharyngeal tonsilloliths. MATERIAL AND METHODS: A total of 515 CT scans were retrospectively re-examined looking for calcifications of the posterior wall of the nasopharynx. One patient with this type of calcification underwent a cerebral MRI as part of the etiological workup of his faintness, which also provided a study of the nasopharyngeal wall. The size, density, and position of these calcium concretions were analyzed with CT in all cases. RESULTS: In 31 patients (18 men, 13 women), we discovered one or several calcifications in the pharyngeal mucous area, between 2 and 5.5 mm in size, with a median density of 202 HU. In two cases, we observed that these calcifications adhered to an adenoid cyst, whereas in three cases, the patients had both palatine tonsil and nasopharyngeal calcifications. None of the 31 patients had previously had an adenoidectomy. Sagittal CT and MRI images clearly localized all these calcifications before the pharyngobasilar fascia. DISCUSSION: The position of these nasopharyngeal calcifications in front of the pharyngobasilar fascia means that a calcified vestige of the notochord can be ruled out. Moreover, the simultaneous presence of nasopharyngeal tonsil and palatine tonsil calcifications in three patients is an additional argument for considering these calcifications of the posterior wall of the nasopharynx as tonsilloliths, all of which, representing 6% of the CTs in our series, were asymptomatic. CONCLUSION: The nasopharyngeal tonsilloliths are stones less than 1 cm in size lodged in the pharyngeal tonsils that are frequently detected on CT when there are no clinical symptoms.     

小儿腺样体肥大的CT表现(附25例分析)

目的分析小儿腺样体肥大的CT表现,探讨其应用价值。方法25例中男20例,女5例,年龄3~15岁。以3mm层厚、3mm层距CT扫描鼻咽部。结果增殖腺样体厚度13~25mm,呈弧扇形14例,呈长条状9例,呈不规则状2例;咽鼓管开口狭窄或消失6例。CT显示并发症:扁桃体肥大13例,副鼻窦炎11例,鼻甲肥大21例,中耳乳突炎2例。结论CT检查能全貌准确显示增殖腺样体及变形狭窄鼻咽腔,同时显示其并发症。CT检查是腺样体增殖术前检查的首选。