CT及MRI在鼻腔鼻窦内翻性乳头状瘤的临床诊断中的应用价值

目的探讨CT及MRI在鼻腔鼻窦内翻性乳头状瘤(sinoasal and nasal inverted papilloma,SNIP)临床诊断中的应用价值。方法回顾性分析我科2012年6月至2015年11月期间行手术病理确诊的SNIP患者100例,术前均有CT及MRI检查,比较CT、MRI、CT结合MRI诊断与病理诊断的符合率,并分析CT、MRI的影像诊断特点。结果 100例SNIP中起源于上颌窦27例,筛窦22例,额窦16例,鼻甲15例,窦口鼻道复合体8例,蝶窦7例,不能确认起源5例;CT与MRI诊断的分期符合率为98.0%,明显高于单独CT或MRI的诊断符合率94.0%、96.0%;CT表现:单侧鼻腔鼻窦软组织病变,骨炎症出现率为63.0%(63/100),与起源部位一致率64.6%(42/65),9例出现眶纸板或前颅底骨质破坏,与恶变有关,MRI表现:97例出现脑回征,86例准确预测起源部位(准确率86.0%)。结论 CT联合MRI检查可全面显示SNIP的范围及其与周围软组织的界线,有助于术前肿瘤临床分期以及肿瘤起源的准确评估,从而更有利于实现早期诊断、早期治疗。

To Investigate the Clinical Value of CT and MRI in the Diagnosis of Sinoasal and Nasal Inverted Papilloma

Objective To investigate the clinical value of CT and MRI in the diagnosis of sinoasal and nasal inverted papilloma (SNIP).Methods A retrospective analysis of 100 cases of SNIP confirmed by surgical pathology in our department from June 2012 to November 2015 who had preoperative CT and MRI, and the CT, MRI diagnostic accordance rate were compared with pathological diagnosis. The CT, MRI diagnostic imaging characteristics were analyzed.Results 27 cases of SNIP origins in the maxillary sinus, 22 and 16 cases in ethmoid and frontal sinus respectively, 15 cases in turbinate and 8 in ostiomeatal complex, 7 cases in sphenoid sinus, the origin of 5 cases remains unknown; CT and MRI diagnosis installments in line with the rate of 98.0% was significantly higher than CT or MRI diagnosis rate of 94.0%, 96.0%; CT manifestations: unilateral nasal sinus soft tissue lesions, bone inflammation occurred was 63.0% (63/100), and the site of origin concordance rate 64.6% (42/65), 9 cases of the orbital or skull base bone destruction, and malignant transformation, MRI findings: 97 cases occurred gyrus syndrome, 86 cases to accurately predict the site of origin (86.0% accuracy).Conclusion CT combined with MRI examination can show the full scope and SNIP and soft tissue boundaries contribute to tumor clinical stage and accurate preoperative assessment of tumor origin, and thus more conducive to early diagnosis and early treatment.