胆脂瘤型中耳炎的HRCT征象分析

目的:探讨胆脂瘤型中耳炎的HRCT征象及其病理基础。方法:胆脂瘤型中耳炎23例,全部经乳突根治术后证实,综合HRCT征象、手术结果、文献资料予以分析。结果:23例胆脂瘤型中耳炎中,呈团块状瘤影18例,伴周边连续或间断低密度圈15例,呈片状瘤影5例;盾板破坏20例,上鼓室外侧壁破坏12例;中耳腔的不同区域扩大伴骨质硬化环16例、破坏4例;听小骨破坏、移位22例;硬化型乳突22例,板障型乳突1例;并发症6例。结论:HRCT能够反映胆脂瘤型中耳炎相对特征性的病理表现,是首选的影像学诊断方法。

Features of cholesteatomatous chronic otitis media under high-resolution CT

Objective:To explore the features of cholesteatomatous chronic otitis media under high-resolution CT(HRCT) and the pathomechanism of this disease.Methods:23 cases were detected by HRCT to have cholesteatomatous chronic otitis media and confirmed by surgery.The data involved HRCT features and related literature were analyzed.Results:Of the 23 cases,18 exhibited the image with mass-like tumor,15 presented shadows with low density ring around the tumor and 5 with flaky shadows.20 cases were seen with the erosion of scutum and 2 with the destruction of the attic lateral wall.Extended focus in tympanic cavity with bony sclerosis-like ring was seen in 16 cases and 4 with destruction.22 cases complicated with destruction and dislocation of the ossicular chain and sclerotic mastoid was seen in the equal cases.1 case presented itself in the image with diploic mastoid and 6 with complications.Conclusion:HRCT may be reliable in diagnosis of cholesteatomatous chronic otitis media,for it can exhibit the major pathological features of this disease.