HRCT在诊断胆脂瘤型慢性中耳炎中的价值研究

目的:探讨胆脂瘤型慢性中耳炎的高分辨率CT(HRCT)表现及诊断价值。材料与方法:回顾分析52例(55耳)经手术和病理证实的胆脂瘤型慢性中耳炎病人的HRCT扫描表现。结果:胆脂瘤型慢性中耳炎HRCT表现有:(1)鼓室、鼓窦、乳突内软组织影,多表现为团块状;(2)听骨移位和破坏;(3)骨壁破坏:盾板骨及鼓室外侧破坏常见。后期可出现乙状窦壁、鼓室天盖、半规和面神经管等的破坏;(4)鼓膜增厚、内陷、穿孔;(5)乳突硬化和骨质破坏。结论:胆脂瘤型慢性中耳炎具有特征性HRCT表现。HRCT扫描能准确诊断早期胆脂瘤,对指导临床治疗有重要意义。

HRCT Diangosis and Pathologic Study of Chronic Otitis Media with Cholesteatoma

Purpose:To study the high-resolution CT (HRCT) features and the value of diagnosis.Materials and Methods:HRCT images of 52 patients (55 ears) with cholesteatoma were analyzed retrospectively.All cases were confirmed by operation and pathology.Results:CT finding of chronic otitis media with cholesteatoma:(1) Abnormal soft-tissue in tympanic cavity and antrum,most was mass-like.(2)The ossicular chain shifted and destroyed.(3)The bony erosion of secutum and lateralis wall of tympanic cavity was common and early.Sigmoid sinus plate,tegment tympanic,semricircular canal,facial nerve canal et al could be destroyed in late cholesteatoma.;Tympanic membrane increased thickness and sunk inside.(5) Mastoid was sclerotic and bone erosion.Conclusion:HRCT features of chronic otitis media with cholesteatoma help or early diagnosis and has significant value for directing clinic treatment.