中耳乳突炎的高分辨CT诊断

目的 :对 42例资料完整 ,其中 2 6例经手术病理证实的中耳乳突炎行回顾性分析 ,探讨其CT特征、诊断及鉴别。方法 :用岛津SCT 30 0 0TX ,以骨算法方式 2mm连续靶CT扫描。 42例中 ,男性 2 2例 ,女性 2 0例 ,临床症状有听力下降、流脓、头痛、耳鸣、眩晕等。结果 :HRCT能清楚显示外耳、中耳、及内耳结构。术前诊断单纯型 16耳 ,肉芽肿型 8耳 ,胆脂瘤型 18耳。 2 6耳诊断为肉芽肿型和胆脂瘤型患者均行手术治疗 ,术前诊断为肉芽肿型 8耳 ,术后 2耳病理证实为胆脂瘤型。 18耳胆脂瘤型术后证实有 3耳为肉芽肿型。结论 :由于HRCT能清晰显示颞骨结构 ,对中耳乳突炎性病变发现及定位较准确 ,对胆脂瘤和肉芽肿型鉴别仍有一定困难。

Diagnosis of Mastoiditis by HRCT

Objective: To analyze the CT features and diagnosis of 43 cases of mastoiditis with clinical diagnosis, including 26 cases proved by surgery, by studying them retrospectively. Methods: All cases were scanned with bone algoritum and level 2 min SCT 300 TX. Among them, 22 were male and 20 femal.Their clinical symptoms were hearing fall, headache, gliddiness and ruming with pus. HRCT can show clearly the structure of the external ear, middle ear and internal ear. Results: CT diagnosis before surgery revealed 16 mastoiditis of simple type 8 of granullomatous type and 18 of cholesteatoma type.All the 26 cases of granullomatous and cholesteatoma type were operated on, but 2 cases were cholesteatoma type in 8 cases of granullomatus type and 3 were granullomatus type in 18 cases of cholesteatoma type.Conclusion:HRCT can correctly diagnose and orientate mastoiditis, but can not easily distinguish granullomatous from cholesteatoma.