胆脂瘤型中耳炎多层螺旋CT术前评估与术中所见对比研究

发布时间：2018-01-16 19:32

本文关键词：胆脂瘤型中耳炎多层螺旋CT术前评估与术中所见对比研究　出处：《昆明医学院》2010年硕士论文　论文类型：学位论文

更多相关文章： 胆脂瘤 中耳炎 多层螺旋CT 符合率

【摘要】： [目的]通过对胆脂瘤型中耳炎患者多层螺旋CT影像学诊断与术中在耳科手术显微镜下所见的对比研究,来评估术前诊断与术中所见的诊断符合率,进而探讨多层螺旋CT对胆脂瘤型中耳炎侵袭范围及骨质破坏程度的临床诊断价值,为选择手术方式、进路及预后判断提供参考标准。 [方法]选择昆明医学院第一附属医院耳鼻咽喉科2008年8月至2009年10月在我科接受手术治疗,术前经多层螺旋CT检查,术后病理检查证实为胆脂瘤型中耳炎的71例患者为研究对象。根据每位研究对象的颞骨多层螺旋CT影像学资料,仔细阅读胆脂瘤病变部位、听骨链破坏情况及中耳毗邻骨质受侵情况等,回顾性对照术中在耳科手术显微镜下所见情况,评估术前诊断与术中所见的诊断符合率。 [结果]术前CT诊断胆脂瘤病变部位128个,而术中证实为124个,符合率为93.5%；术前CT诊断听骨链破坏183个,而术中证实为167个,诊断符合率为88%；术前CT诊断中耳毗邻骨质受侵部位147个,术中证实为135个,诊断符合率为91.9%。 [结论]对于胆脂瘤型中耳炎,多层螺旋CT影像学诊断与耳科手术显微镜下所见基本一致,多层螺旋CT能直观、准确地显示胆脂瘤病变部位、听骨链破坏情况以及毗邻骨质破坏的范围,是可靠的诊断方法,对制定手术方案和评估治疗效果,具有重要的指导意义。
[Abstract]:[Objective] to evaluate the coincidence rate between preoperative diagnosis and intraoperative diagnosis of cholesteatoma otitis media by comparing the imaging diagnosis of multi-slice spiral CT with that of the operation under the microscope. To explore the clinical value of multi-slice spiral CT in the diagnosis of cholesteatomatous otitis media invasion and the degree of bone destruction, and to provide a reference standard for the selection of surgical methods, approach and prognosis. [Methods: the department of otolaryngology and otolaryngology of the first affiliated Hospital of Kunming Medical College was operated in our department from August 2008 to October 2009 and was examined by multi-slice spiral CT before operation. After operation, 71 patients with cholesteatoma type otitis media proved by pathological examination were studied. According to the imaging data of multi-slice spiral CT of temporal bone of each patient, the location of cholesteatoma was carefully read. The destruction of ossicular chain and the condition of osseous invasion adjacent to middle ear were analyzed retrospectively. The coincidence rate between preoperative diagnosis and intraoperative diagnosis was evaluated. [Results: 128 lesions of cholesteatoma were diagnosed by CT before operation, while 124 were proved during operation, the coincidence rate was 93.5. Preoperative CT diagnosis of ossicular chain destruction 183, but intraoperative proved 167, the diagnostic coincidence rate is 88. Preoperative CT diagnosis of 147 sites adjacent to the middle ear, 135 confirmed during the operation, the diagnostic coincidence rate was 91.9%. [Conclusion: for cholesteatoma otitis media, the imaging diagnosis of multi-slice spiral CT is consistent with that under the microscope of ear surgery. Multi-slice spiral CT can visualize and accurately display the location of cholesteatoma. The destruction of ossicular chain and the extent of adjacent bone destruction are reliable diagnostic methods.
【学位授予单位】：昆明医学院
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R764.21

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