筛蝶窦囊肿的临床和影像学诊断

目的:分析总结筛蝶窦囊肿的临床表现和影像学特点,探讨影像学检查在筛蝶窦囊肿诊断中的意义.材料和方法:回顾性分析20例手术证实的筛蝶窦囊肿病例(男16例,女4例;年龄10～68岁,中位数为44岁),病理显示均合并囊肿壁黏膜慢性炎症,其中伴胆固醇肉芽肿2例和内翻性乳头状瘤样改变1例.影像学检查包括CT检查14例、MRI检查16例,其中3例完成了CT增强检查.结果:临床表现以头痛(14例)和眼部症状(7例)(包括视力下降、复视、突眼、上睑下垂等)为主,其他还有鼻部症状4例(鼻塞、鼻出血等)以及短暂意识丧失、性功能障碍、泌乳、月经减少、面部麻木等.病程1～48个月,中位数17个月.CT显示囊肿为窦腔内膨胀性占位,CT值15～57Hu,部分有骨质吸收,边缘清晰;MRI显示囊肿为T1WI上信号强度不一,T2WI高信号.3例CT增强有环形或结节状强化,对应病理为合并肉芽肿形成或乳头状瘤样变.结论:筛蝶窦囊肿的临床表现结合影像学表现有一定特点,影像学检查在其诊断中有重要作用.

Clinical and Imageologic Diagnosis of Mucoceles of Ethmoid and Sphenoid Sinuses

Purpose: To study the clinical manifestation and CT/MRI findings in mucoceles of ethmoid and sphenoid sinuses and evaluate CT/MRI in diagnosis. Materials and Methods: 20 documented cases(16 male, 4 female , ages from 10 to 68years) with ethmoid and sphenoid cyst were evaluated respectively. Pathologic examination revealed chronic mucosal inflammation, and cholesterol granuloma in 2 and papillary tumor-like in 1. Results: The main clinical manifestation was headache and eyes symptoms, others included nose symptoms. The mucoceles were bulgy and waterlike density on CT scan, and bone absorption of sinus walls were found. There were various signal intensities on T1 - weighted images and high signal on T2 -weighted images. Heterogenous enhancement were found in 3 CT scan, and the corresponding pathology showed cholesterol granuloma papillary tumorlike.Conclusion: Mucoceles of ethmoid and sphenoid sinuses would have some special clinical manifestations and CT/MRI characteristics, and CT/MRI play an important role in its diagnosis.