Ethmoid sinus disease: CT evaluation in 400 cases. Part I. Nonsurgical patients.
Ethmoid sinus disease: CT evaluation in 400 cases. Part I. Nonsurgical patients.
复制标题
筛窦病：400例CT评估。
作者：
P. Som;W. Lawson;H. Biller;C. Lanzieri
筛窦独特的解剖结构使得“软组织混浊”难以解释，尤其是在平片上。筛房内孤立性或全身性软组织疾病的临床意义尚不清楚，在建立特异性鉴别诊断时，必须依赖骨侵蚀或骨重建的模式。在研究的400名患者中，186名患有炎症性疾病，214名患有肿瘤。鳞状细胞癌、转移瘤和少数侵袭性肉瘤几乎完全以骨质破坏为特征，而其余94%的肿瘤以空腔重塑为特征。由于肿瘤增强的模式和程度，有时可能进一步分化。肿瘤中只有小涎腺病变和神经瘤有不均匀强化。恶性病变不能诊断与计算机断层扫描（CT），除非骨破坏存在。同样，尽管化疗期间持续的良性软组织病变的意义尚不清楚，但即使在CT表现稳定数月后，也必须始终怀疑肿瘤。
The unique anatomy of the ethmoid sinuses makes it difficult to interpret "soft-tissue clouding," especially on plain films. The clinical significance of isolated or generalized soft-tissue disease within ethmoid cells is unclear, and the patterns of bone erosion or remodeling must be relied on in establishing a specific differential diagnosis. Of 400 patients studied, 186 had inflammatory disease and 214 had tumors. Squamous cell carcinomas, metastases, and a few aggressive sarcomas were found almost exclusively to have bone destruction, while 94% of the remaining neoplasms were characterized by cavity remodeling. Further differentiation was sometimes possible because of the pattern and degree of tumor enhancement. Of the neoplasms, only the minor salivary gland lesions and neuromas had nonhomogeneous enhancement. Malignant lesions cannot be diagnosed with computed tomography (CT) unless bone destruction is present. Similarly, although the significance of persistent, benign-appearing soft-tissue disease during chemotherapy is unclear, tumor must always be suspected, even after many months of a stable CT appearance.