中耳腺瘤的CT与MRI特征分析

发布时间：2018-08-16 14:55

【摘要】：目的:分析中耳腺瘤的CT、MRI特征,结合临床表现探讨影像学检查对中耳腺瘤术前诊断及鉴别诊断的意义。方法:回顾2004-2014年在首都医科大学附属北京同仁医院耳科接受手术治疗并经病理检查证实的8例中耳腺瘤患者的完整病例资料,包括临床表现与体征、纯音测听、颞骨CT与MRI检查结果。结果:8例患者有听力下降伴耳鸣或耳闷,2例伴有耳痛,其中1例伴周围性面瘫。5例鼓膜膨隆,2例肿物穿透鼓膜生长至外耳道,1例鼓膜正常。纯音测听4例表现为传导聋,4例表现为混合聋。颞骨CT检查7例可见鼓室、乳突软组织影,均包埋听骨链,骨质无明显破坏,其中2例鼓室软组织影向外耳道突出,1例软组织影局限于中鼓室。内耳MRI检查5例表现为鼓室等T1等T2信号影,增强后明显强化;乳突腔长T1或等T1、长T2信号影,无强化,提示阻塞性炎症。结论:中耳腺瘤的颞骨CT特征为鼓室软组织影不伴骨质异常,内耳MRI特征为鼓室等T1等T2信号、明显强化结节影。结合中耳腺瘤的临床特点,有助于该病的术前诊断。
[Abstract]:Objective: to analyze the CT MRI features of middle ear adenoma and to explore the significance of imaging examination in preoperative diagnosis and differential diagnosis of middle ear adenoma. Methods: the complete data of 8 patients with middle ear adenoma, including clinical manifestations and signs, pure tone audiometry and confirmed by pathological examination, were reviewed retrospectively from 2004 to 2014 in the otology department of Tongren Hospital affiliated to Capital Medical University. Ct and MRI findings of temporal bone. Results 8 cases had hearing loss with tinnitus or tightness 2 cases with earache, one case with peripheral facial paralysis, 2 cases with swelling of tympanic membrane and 2 cases with swelling of tympanic membrane, and 1 case with normal tympanic membrane. Pure tone audiometry showed conductive deafness in 4 cases and mixed deafness in 4 cases. In 7 cases of temporal bone CT examination, soft tissue shadow of tympanum and mastoid process was found in 7 cases. The ossicular chain was embedded in all cases, and no obvious destruction of bone was found. In 2 cases, the soft tissue shadow of tympanum projecting into the external auditory canal was found in 1 case, and the soft tissue shadow was confined to the middle tympanic chamber. MRI of the inner ear showed T 1 and T 2 signal intensity in the tympanum of 5 cases, and long T 1 or T 1 in mastoid cavity, no enhancement in mastoid cavity, suggesting obstructive inflammation. Conclusion: the CT features of temporal bone of middle ear adenoma are that the soft tissue shadow of tympanum is not accompanied by bone abnormality, while the MRI of inner ear is characterized by T 1 and T 2 signal intensity of the middle ear adenoma, and the nodular shadow is enhanced obviously. Combined with the clinical features of middle ear adenoma, it is helpful for preoperative diagnosis.
【作者单位】：首都医科大学附属北京同仁医院耳鼻咽喉头颈外科;首都医科大学附属北京同仁医院影像科;
【分类号】：R764.21

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