鼻窦积液CT值对脑脊液鼻漏患者的诊断意义

目的探讨测量鼻窦积液cT值对脑脊液鼻漏患者的诊断，为临床诊断脑脊液鼻漏提供更多的依据。方法回顾性总结37例窦腔积液的脑脊液鼻漏患者术前cT资料，其中18例窦腔积液位于筛窦和额窦、10例位于蝶窦和筛窦、4例位于筛窦、3例位于蝶窦、2例位于额窦。重点分析其窦腔积液中心区域的CT值及术中所见。结果37例患者颅底漏口部位与CT检查结果基本一致。18例窦腔积液CT值在3—20HU，术中未见明显积液或仅见少量淡红色清液；15例CT值在23～50HU，术中窦腔可见炎性分泌物；4例CT值67～85HU，术中窦腔可见陈旧血块。结论测量鼻窦积液的CT值，可大致反应积液的性质。临床上可作术前诊断参考，也可作为脑脊液鼻漏修补术后随访的观测指标。

The diagnostic significance of CT value in cerebrospinal fluid rhinorrhea

Objective To investigate the diagnostic significance of CT value in cerebrospinal fluid rhinorrhea and to provide infomlation for early diagnosis. Methods Clinical data of 37 cases with cerebrospinal fluid rhinorrhea confirmed by operation was analyzed retrospectively. All patients had CT scan which showed basal skull fractures and fluid accumulation of sinus , including frontal and ethmoid sinus （ n = 18 ） , sphenoid and ethmoid sinus （n = 10） , ethmoid sinus （n =4） , sphenoid sinus （n =3） , frontal sinus （n = 2）. The CT value of central accumulation area was calc,dated and compared with surgical findings respectively. Results The CT scan gave precise localization of the basal skull fracture. Of the 37 case, l 8 had clear sinus fluid with CT value of 3 to 20 HU, 15 had opaque sinus fluid with CT value of 23 to 50 HU, and 4 had blood sinus fluid with CT value of 67 to 85 HU. Conclusion CT value in sinus fluid has specific significance in the diagnosis and postoperative followup of cerebrospinal fluid rhinorrhea.