单侧上颌窦占位性病变的CT诊断

目的探讨CT扫描对常见的单侧上颌窦占位性病变的诊断意义。方法回顾性总结2006年1月～2008年1月我科治疗的108例单侧上颌窦占位性病变患者的临床及影像学资料，并以组织病理学结果作为对照，对比分析CT扫描在单侧上颌窦占位性病变中的诊断意义。结果108例单侧上颌窦占位性病变中慢性上颌窦炎36例（33．3％），上颌窦肿瘤32例（29．6％），真菌性上颌窦炎19例（17．6％），上颌窦囊肿14例（13．0％），上颌窦后鼻孔息肉5例（4．6％），上颌窦出血坏死性息肉及上颌窦嗜酸性肉芽肿各1例（0．9％）。大多数上颌窦占位性病变都具有其特有的临床及影像学表现，鼻窦CT扫描在单侧上颌窦占位性病变的术前诊断总体准确率为79．1％；其中上颌窦囊肿的术前诊断准确率为92．9％，慢性上颌窦炎为90．0％，上颌窦癌为80．0％，真菌性上颌窦炎为86．4％，鼻内翻性乳头瘤为50．0％。结论CT扫描对单侧上颌窦占位性病变的术前诊断有着十分重要的作用，大多数病变通过鼻窦CT检查可以作出初步的定位或定性诊断，并制定出合理的手术方案，最终确诊仍有赖于组织病理学检查。

Diagnostic value of CT in occupying lesion of unilateral maxillary sinus

Objective To determine the diagnostic value of CT in occupying lesion of unilateral maxillary sinus. Methods Clinical and CT image data of 108 cases of occupying lesion of unilateral maxillary sinus treated in our department from Jan. 2006 to Jan. 2008 were analyzed retrospectively. The diagnostic value of CT in occupying lesion of unilateral maxillary sinus was analyzed regarding the histopathologic results as ＂ golden standard ＂ . Results Of all the 1 0 8 cases investigated , 3 6 （ 3 3 . 3 % ） were chronic maxillary sinusitis , 32 （29. 6% ） were maxillary tumor, 19 （ 17. 6% ） were fungal maxillary sinusltis, 14 （ 13. 0% ） were maxillary cyst 5 （ 4. 6 % ） were antro - choanal polyp , maxillary bleeding necrotic polyp and maxillary eosinophilic granuloma accounted for one case respectively. The comparative results indicated that most occupying lesions of unilateral maxillary sinus showed specific clinical characteristics and CT image. The accurate rate of CT scan applied to the diagnosis of occupying lesions of unilateral maxillary sinus varied with the accurate rates for maxillary cyst, chronic maxillary sinusitis, carcinoma of maxillary sinus, fungal maxillary sinusitis and maxillary inverting papilloma were 92.9 % , 90. 0 % , 80. 0 % , 86. 4 % , and 50. 0 % , respectively. The overall accurate rate was 79. 1%. Conclusion CT scan can play an important role in the preoperative diagnosis of occupying lesions of unilateral maxillary sinus, especially for the primary locative and qualitative diagnosis and reasonable surgical scheme. The accurate diagnosis however should still base on histopathologic examination.