- 期刊
黴菌性鼻竇炎的電腦斷層判讀
Computerized Tomography Evaluation of Fungal Sinusitis
摘要
黴菌性竇炎，近年來仍有不少新的病例產生，惟其術前的診斷卻是相當不易；往往需經由臨床症狀、理學檢查、放射線學檢查、血液及血清、生化及免疫測定、黴菌培養和病理切片等繁多的檢查項目來幫忙診斷。電腦斷層檢查，是簡單而快速的輔助診斷工具之一，尤其是對黴菌性鼻竇炎術前的評估、治療及雲後皆相當重要。本文針對48個經病理切片證實為黴菌性鼻竇炎病例；根據文獻上放射線學的發現及臨床判讀電腦斷層片子的經驗，有6項的判讀標準：1.單側侵犯2.鼻竇內有異質性軟組織腫塊3.無氣液相的界面4.鼻竇內側壁有骨壁腐蝕或壓迫相5.鼻竇的竇壁呈渾濁化增厚現象6.有鈣化點；依其相關組合條件的情形，以其有較高的診斷率。
關鍵字
黴菌性鼻竇炎並列摘要
There is an increasing number of reports of fungal sinusitis in recent years. However, the pro-operative diagnosis of fungal sinusitis remains difficult. Computerized tomography (CT) of the paranasal sinusitis is still a simple and quick diagnostic method. According to the reports of the literature and our clinical experiences, we summarized six criteria of CT findings of fungal sinusitis: 1)unilateral involvement 2)heterogeneous soft tissue mass in the involved sinuses 3)no air-fluid level in the involoved sinuses 4)erosion or compression of the medial sinus wall 5)opacification or thickness of the anterior and lateral sinus walls 6)calcified spot in the involved sinuses. Retrospective studies of the CT films of forty-eight patients with pathologyproved fungal sinusitis were done to assess the incidence of the criteria of CT findings. We hope that the outcome of the studies would be of benefits for us to make a more accurate preoperative diagnosis of this disease.