摘要目的 比较西门子64排CT与1.5T MRI检查对鼻腔鼻窦内翻性乳头状瘤(SNIP)的价值.方法 选取吕梁市人民医院于2008年6月至2017年6月期间收治的200例鼻腔鼻窦内翻性乳头状瘤患者,所有患者均经过手术病理确诊,并且术前均采取MRI和CT检查,以病理诊断作为临床诊断的黄金标准,分析MRI和CT两种检查方案和病理诊断的符合率.结果 病理检查的分期检出率和起源部位检出率均显著高于CT检查(13.00%、35.00%、45.00%、7.00%、100.00%比10.00%、21.00%、53.00%、16.00%、85.00%;χ2 ＝8.273,χ2 ＝15.273,均 P ＜0.05);病理检查和 CT 两种检查方式的恶性检出率差异无统计学意义(100.00%比75.00%;χ2 ＝1.923,P＞0.05).病理检查和MRI两种检查方式的分期检出率和起源部位检出率差异无统计学意义(13.00%、35.00%、45.00%、7.00%、100.00%比11.00%、37.00%、44.00%、8.00%、97.00%;χ2 ＝0.384,χ2 ＝2.073,均 P ＞0.05);病理检查的恶性检出率为100%,显著高于 MRI 检查的25.00%(100.00%比25.00%;χ2 ＝9.923,P＜0.05). MRI检查的恶性检出率为25.00%,显著低于CT检查的75.00%(χ2 ＝4.233,P＜0.05);MRI检查的分期检出率和起源部位检出率均显著高于CT检查(11.00%、37.00%、44.00%、8.00%、97.00%比10.00%、21.00%、53.00%、16.00%、85.00%;χ2 ＝7.384,χ2 ＝8.073, P＜0.05).结论 对鼻腔鼻窦内翻性乳头状瘤的早期诊断和治疗分别采用CT和MRI进行检查各有利弊, MRI检查有助于对患者术前肿瘤的临床分期及其肿瘤起源作出准确评估.

abstractsObjective To compare the clinical value of Siemens 64 row CT and 1.5 T MRI in the diagnosis of sinonasal inverted papilloma (SNIP).Methods From June 2008 to June 2017,200 patients with inverted papilloma of the nasal cavity and paranasal sinuses admitted to Lyuliang People ˊs Hospital were selected.All patients were confirmed by surgery and pathology ,and preoperative MRI and CT examination were adopted.Pathological diagnosis was taken as the gold standard for clinical diagnosis ,and the coincidence rate of MRI and CT examination with patho－logical diagnosis was analyzed.Results The detection rate of disease stage and origin site of pathological examination was significantly higher than those of CT examination (13.00%,35.00%,45.00%,7.00%,100.00%vs.10.00%, 21.00%,53.00%,16.00%,85.00%,χ2 ＝8.273,15.273,all P ＜0.05).There was no statistically significant difference in the malignant detection rate between disease detection and CT (100.00%vs.75.00%;χ2 ＝1.923,P＞0.05).There was no statistically significant difference in the detection rate of stage and origin site between the two examination methods (13.00%,35.00%,45.00%,7.00%,100.00% vs.11.00%,37.00%,44.00%,8.00%, 97.00%;χ2 ＝0.384,2.073,all P＞0.05).The malignant detection rate of pathological examination was 100%, which was significantly higher than that of MRI (100.00%vs.25.00%;χ2 ＝9.923,P＜0.05).The malignant rate of MRI examination was 25.00%,which was significantly lower than that of CT examination (χ2 ＝4.233,P＜0.05). The detection rates of stage and origin site in MRI examination were significantly higher than those in CT examination (11.00%,37.00%,44.00%,8.00%,97.00% vs.10.00%,21.00%,53.00%,16.00%,85.00%;χ2 ＝7.384, 8.073,all P＜0.05).Conclusion There are advantages and disadvantages in the early diagnosis and treatment of inverted papilloma of nasal cavity and paranasal sinuses by CT and MRI ,respectively.Therefore,it is suggested that CT and 1.5T MRI should be used together.The extent of the disease and the boundary between the disease and the surrounding soft tissue are more comprehensive ,which is helpful to accurately evaluate the clinical stage and origin of the tumor before operation.