儿童腺样体肥大的CT表现

目的 探讨儿童腺样体肥大的CT表现。资料与方法 回顾分析32例经手术病理证实的儿童腺样体肥大的CT表现。结果 儿童腺样体肥大的CT征象为：鼻咽顶后壁软组织增厚堵塞后鼻孔14例,合并副鼻窦炎12例,合并分泌性中耳炎6例,增强扫描病灶不均匀强化。结论 CT检查可以明确病灶范围及其合并症。     

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。     

小儿腺样体肥大的CT表现

腺样体肥大是儿童常见病,肥大的腺样体可导致鼻咽腔、气道结构的狭窄,从而引起呼吸不畅,导致呼吸睡眠障碍,同时可合并副鼻窦炎以及中耳乳突炎,引起听力下降[1]。搜集我院2000~2006年58例小儿腺样体肥大患者与49例正常者的CT资料进行对比分析,旨在探讨腺样体肥大的CT表现及诊断标准。1材料与方法1·1腺样体肥大组58例患者中,男32例,女26例,年龄2~14岁,中位年龄7·6岁,均具备以下条件:①有腺样体肥大的相关症状,如反复鼻塞流涕、反复咳嗽、咽异物感、打鼾、张口呼吸、听力下降等。②鼻咽镜发现腺样体黏膜充血及表面纵沟改变或有分泌物。③C…     

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。     

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。     

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。     

528例分泌性中耳炎患儿腺样体的CT表现

目的:分析分泌性中耳炎患儿鼻咽腺样体肥大的16层MDCT表现.方法:对528例被确诊为分泌性中耳炎的小学生进行鼓膜检查、听力检查、声阻抗检查和鼻咽部横断面CT平扫检查并比较.结果:528例被确诊为分泌性中耳炎的小学生均有不同程度的鼻咽腺样体肥大和听力损失,并且鼻咽腺样体肥大的程度与听力损失的程度和比率呈正相关.结论:16-MDCT扫描可清楚显示鼻咽腺样体肥大及其程度,对分泌性中耳炎患儿鼻咽腺样体肥大的临床治疗有重要的指导价值.     

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.     

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   

儿童腺样体肥大的X线诊断分析(附120例报告)

目的探讨鼻咽部侧位CR片对儿童腺样体肥大的诊断价值。方法收集经临床及手术证实的儿童腺样体肥大120例,均摄取鼻咽部侧位CR片,测量顶后壁软组织厚度(A值)和鼻咽腔宽度(N值),并计算A/N比值。结果120例儿童腺样体肥大病例鼻咽部顶后壁软组织均不同程度增厚,为13.7~27.3 mm,均值达21.9 mm,并可见鼻咽腔不同程度受压变窄,A/N比值平均比率>0.70,达0.80。结论鼻咽部侧位CR片测量,是一种简便准确可行的儿童腺样体肥大的诊断方法。     

鼻咽部良性病变的CT诊断(附33例分析)

目的：探讨鼻咽部良性病变的CT表现和鉴别诊断。资料与方法：分析33例鼻咽部良性病变的CT资料，重点观察病变部位、咽旁软组织间隙、咽缝、副鼻窦及颈部淋巴结改变。结果：（1）单纯咽隐窝膨隆或突出5例；（2）后顶壁软组织增厚或“山丘”状突起或合并咽隐窝闭塞28例；（3）25例咽缝存在，14例合并副鼻窦炎症。结论：单纯后顶壁软组织增厚不累及咽缝，无咽旁间隙侵犯和颈部淋巴结恶性转移征象者可作出良性病变CT诊断：咽隐窝膨隆或肿块，确诊依靠病理活检。     

鼻咽癌放射治疗的CT观察(附30例分析)

目的：观察鼻咽癌放射治疗后不同时期的ＣＴ表现,探索期肿瘤变化规律,观察放疗后鼻咽部的改变及原发部位肿瘤复发的特点。方法：应用ＣＥ９８００－Ｑｕｉｃｋ ＣＴ机对３０例病人作鼻咽部常规轴位扫描,所有病例进行增强扫描。结果：３０例病人放疗后在ＣＴ上鼻咽部均有不同的表现。８例病人双侧鼻咽部结构对称,１５例鼻咽癌有不同程度的放疗的改变,表现为咽壁僵直,咽旁软组织增厚,咽隐窝变平,咽彭管闭塞,鼻咽腔扩大,１７     

CT of nasopharyngeal carcinoma: significance of widening of the preoccipital soft tissue on axial scans

Axial CT scans of 60 patients with biopsy-proved nasopharyngeal carcinoma were reviewed with particular reference to sites of origin and routes of spread of disease. In all patients there was involvement of the pharyngeal space with blunting of the fossa of Rosenmuller and usually associated thickening of the adjacent levator veli palatini muscle. Tumor infiltration through the pharyngobasilar fascia manifested by obliteration or displacement of the parapharyngeal fat space was seen in 65% of the patients. T-staging by CT showed T1 (28%), T2 (20%), T3 (5%), and T4 (47%) involvement. In three patients there was bilateral symmetric blunting of the fossa of Rosenmuller with no evidence of tumor infiltration into the parapharyngeal space. The scans were initially interpreted as normal except for widening of the preoccipital soft-tissue area in the midline of more than 1.5 cm and up to 2.0 cm in the anteroposterior plane. Biopsy of the postnasal space was positive for tumor in these patients. With symmetric, early stage nasopharyngeal carcinoma, a confident radiologic diagnosis on CT can be difficult. If there is asymmetry of pharyngeal mucosal space or evidence of deep infiltration this should not be a problem. Although lymphoid adenoid tissue can sometimes result in widening of the preoccipital area, it is proposed that widening of this area of greater than 1.5 cm is an additional CT sign of nasopharyngeal carcinoma not previously emphasized. It is the result of early submucosal infiltration of the disease, and a patient with clinically suspected nasopharyngeal carcinoma should have aggressive deep biopsies of the fossa of Rosenmuller.     

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。     

Role of CT in radiotherapy radiation planning for tumors of the rhinopharynx

The authors compare the results obtained by CT with clinics and conventional radiography in the staging of nasopharyngeal tumors. The accurate evaluation of tumor size, localization, and spread, helps optimize treatment planning and fit radiation boosts on small fields. Twenty-six patients underwent clinical examination, radiography of the skull and neck, lateral stratigraphy of epipharynx, and CT of head and neck. We compared the results obtained in the study of: nasopharyngeal walls, parapharyngeal space, paranasal sinuses, nasal cavity, bone erosion of the base of skull, and continuous invasion without bone erosions. Our results point to conventional radiology as the examination of choice for the study of upper nasopharyngeal wall, while CT allows a better evaluation of the lateral wall, and is clearly superior in demonstrating parapharyngeal space, contiguous intracranial invasion, and neck nodes involvement.     

MRI在鼻咽癌肿瘤分期中的价值

目的 :探讨MRI在鼻咽癌 (NPC)肿瘤分期中的价值。方法 :回顾性分析了 2 4 0例经病理证实的NPC ,MRI平扫后增强扫描并加扫冠状扫描和矢状面。结果 :依NPC浸润方式分为内外、前后、上下 6个方向对肿瘤行MRI分期 :T1期 (向内 ) :肿瘤局限在鼻咽壁 2 5例 ;T2期 (向外和向后 )侵及咽旁浅间隙 80例 ,侵及咽旁深间隙 37例 ,侵及咽后间隙 2 6例 ;T3期 (向前和向下 )侵及鼻腔、上颌窦、蝶窦和口咽 4 4例 ;T4期 (向上侵及颅底、颅内 ) 2 8例。结论 :MRI有助于鼻咽癌的诊断和准确肿瘤分期。     

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。     

Sinonasal computed tomography in patients with Wegener's granulomatosis

The goal of this study was to describe pathologies of sinonasal CT in patients with Wegener's granulomatosis. Between 1993 and 2004, sinonasal CT was performed in 28 patients (15 male, 13 female) with Wegener's granulomatosis. The following imaging findings were assessed on the CT scans: mucosal thickening, subtotal opacification, air-fluid level, bony destruction, sclerosing osteitis, bony thickening, orbital mass, and saddle nose deformity. Of the 28 patients, 61% showed mucosal thickening in the nasal cavity and 75% in the paranasal sinuses. A subtotal opacification of the paranasal sinuses was detected in 25%, and of the mastoid cells in 7% of patients. Fifty-seven percent of patients had bony destruction of the nasal cavity, and 54% of the paranasal sinuses. CT revealed sclerosing osteitis of the paranasal sinuses in 21%, and of the mastoid cells in 18% of patients. Bony thickening of the paranasal sinuses was detected in 18%, and of the mastoid cells in 14% of patients. With respect to all imaging findings, the maxillary sinuses were the most frequently affected paranasal sinuses. The authors conclude that the following sinonasal CT findings are observed in patients with Wegener's granulomatosis: (1) bony destruction, mainly of the nasal cavity, maxillary sinuses, and mastoid cells; (2) sclerosing osteitis, mainly of the maxillary sinuses and mastoid cells; (3) bony thickening, mainly of the maxillary sinuses and mastoid cells; and (4) mucosal thickening, mainly of the maxillary sinuses. These findings are, however, nonspecific and should be combined with other clinicopathologic and laboratory studies to confirm the diagnosis of Wegener's granulomatosis.     

Paranasal sinuses and nasopharynx CT and MRI

Neoplastic disease of the nose, paranasal sinuses, the nasopharynx and the parapharyngeal space requires thorough assessment of location and extent in order to plan appropriate treatment. CT allows the deep soft tissue planes to be evaluated and provides a complement to the physical examination. It is especially helpful in regions involving thin bony structures (paranasal sinuses, orbita); here CT performs better than MRI. MRI possesses many advantages over other imaging modalities caused by its excellent tissue contrast. In evaluating regions involving predominantly soft tissue structures (ec nasopharynx and parapharyngeal space) MRI is superior to CT. The possibility to obtain strictly consecutive volume data sets with spiral CT or 3D MRI offer excellent perspectives to visualize the data via 2D or 3D postprocessing. Because head and neck tumors reside in a complex area, having a 3D model of the anatomical features may assist in the delineation of pathology. Data sets may be transferred directly into computer systems and thus be used in computer assisted surgery.