螺旋CT仿真内窥镜对鼻腔鼻窦占位性病变的研究

目的:探讨螺旋CT仿真内窥镜对鼻腔鼻窦占位性病变的显示能力和临床应用价值. 方法:收集临床疑为鼻部占位病变的患者30例60侧鼻腔,分别进行CT仿真内窥镜检查(CTVE)、硬管内窥镜检查(RE),将两种检查方法所得显示结果进行对比研究,并利用Wilconxon W test 和X test进行统计分析.结果:CTVE与RE对鼻腔解剖结构和占位性病变的显示有良好的一致性,可完整显示鼻腔内大部分未受侵犯的结构及大的病变,但无法显示粘膜和病变的颜色,有时会遗漏较小的病变. CTVE较RE更好地显示鼻窦的解剖结构和鼻窦内的占位性病变而不需要破坏窦壁. 结论:CTVE的影像与RE相似,同时具有操作简便、无创性、多入路方式及多观察方向的特点.在鼻腔病变的诊断上,CTVE可作为RE一种补充手段;CTVE对鼻窦病变的诊断较RE有明显优势,可作为一种主要手段应用于临床.

Function and clinical application of CT virtual endoscopy in space occupying lesion in the nasal cavity and the paranasal sinuses

Objective: To evaluate the display function and clinical application of CT virtual endoscopy (CTVE) in space occupying lesion in the nasal cavity and the paranasal sinuses. Methods: Sixty nasal cavities of 30 patients were examined with CTVE and rigid endoscopy (RE) respectively. Space occupying lesion of all the cases were proved by nasal sinus surgery and pathology. The results from the two methods were compared and analyzed by using Wilconxon W test and X test statistic software. Results: Both methods showed better consistency, and both could display most of the noninvasive structures and major lesions but failed to display the color of both the mucosa and lesion, with occasional omission of minor lesions. CTVE is superior to RE in displaying the paranasal sinuses anatomic structure and its space occupying lesions without destroying the sinuses wall. Conclusions: CTVE is similar to RE in the access way and mirror image. The former has the characteristics of convenient manipulation, noninvasive examination, multiple access ways and display directions. CTVE can be used as a supplement to RE in the diagnosis of nasal cavity diseases and as a primary examining means in the diagnosis of paranasal sinuses diseases. And it can be introduced into the clinical applicatin as a new way.