查詢結果分析
相關文獻
頁籤選單縮合
題 名 | Wegener's Granulomatosis:Image Findings in Head and Neck=Wegener's肉芽腫:頭頸部的影像表徵 |
---|---|
作 者 | 張豐基; 凌憬峰; 陳行素; 羅兆寶; 郭萬祐; 姜仁惠; 鄧木火; | 書刊名 | 中華放射線醫學雜誌 |
卷 期 | 22:5 1997.10[民86.10] |
頁 次 | 頁199-205 |
分類號 | 414.93 |
關鍵詞 | 頭電腦斷層; 頭磁振造影; 頸電腦斷層; 頸磁振造影; 血管炎; Wegener's肉芽腫; Head CT; Head MRI; Neck CT; Neck MRI; Vasculitis; Wegener's granulomatosis; |
語 文 | 英文(English) |
中文摘要 | Wegener's肉芽腫是一種全身性壞死性的血管炎,經常以侵犯頭頸部為其最早表現,許多病人不容易在早期被診斷而延誤治療,本文的目的是希望找出Wegener's肉芽腫在頭頸部常見的影像表徵進而協助早期診斷這個病病。我們研究了本院過去十五年來,經由臨床及病理確定診斷為Wegener's肉芽腫的十七個病人的影像表徵及臨床症狀,結果發現常見的臨床症狀包括鼻塞,呼吸困難,聽力及視力受損,眼球凸出及聲音沙啞,其中七個病人檢測血清中c-ANCA濃度,結果均呈陽性反應,十三個病人接受顱部X光檢查,主要的X光檢查發現為副鼻竇及乳突氣室變模糊。所有的十七個病人均接受頭頸部電腦斷層檢查,常見的電腦斷層檢查發現為副鼻竇內黏液積存,副鼻竇或鼻腔的軟組織增厚,聲門下狹窄合併腫塊,構成副鼻竇的骨骼增厚,眼眶內腫塊及乳突氣室內液體積存。有二例接受磁振造影檢查,磁振造影可更清楚的看到病灶。十七個病人中的七人發現有聲門下狹窄合併腫塊,較過去的報告高出許多;眼眶內腫塊常合併眼球凸出及鼻竇或鼻腔的病灶。所以有下列影像學的發現時,我們必須將Wegener's肉芽腫列入鑑別診斷,它們包括:不明原因的聲門下狹窄,反覆發作的鼻竇炎或中耳炎且一般治療無效,眼眶內腫塊合併眼球凸出,鼻腔內破壞性腫塊及合併肺臟,腎臟或其他全身性病灶。此外,Wegener's肉芽腫的頭頸部病灶在磁振造影的TIWI及T2WI均可表現出低訊號,亦具有相當的特徵性。 |
英文摘要 | Wegener's granulomatosis is a .systemic necrotizing granulomatousvasculitis that in its earliestpresentation frequently involves thehead and neck. Offen it is notdiagnosed at its initial stage somanagement of the disease isdelayed. We believe in determiningthe common image findings ofWegener's granulomatosis will helpin early diagnosis of this disease. Inthis study, we retrospectivelyreview 17 cases of clinically andpathologically proved Wegener'sgranulomatosis seen in our hospitalfrom Sep 1982 to Apr 1997. Theclinical findings, plain films, CTscan and MRI were reviewed.Serum titers of c-ANCA were testedin 7 of the 17 patients. The resultsshowed that the common clinicalpresentations were nasalobstruction, dyspnea, hearingimpairment, visual impairment,proptosis, and hoarseness. All ofthe 7 cases tested with serum titersof c-ANCA showed positive results.The major findings of the plainfilms were obliteration of paranasalsinuses or mastoid air cells. Thecommon CT findings were fluidcollection in the paranasal sinuses,soft tissue thickening along theinner wall of paranasal sinuses ornasal chamber, subglottic stenosis with enhanced soft tissue mass,orbital mass lesion, scleroticchange of the wall of paranasalsinuses and fluid collection in themastoid air cells. MRI findings in 2patients detected the extension ofthe lesion more clearly. Subglotticstenosis with mass lesions werepresent in 7 of our 17 cases (41)and the ratio was higher than inthose previously reported in theliterature. Mass lesions orinfiltrations in orbital cavity werefrequently associated withproptqsis and disorders of theparanasal sinuses or the nasalchamber. The image findings whichalerted us to initiated Wegener'sgranulomatosis into differentialdiagnosis included: unexplainedsubglottic stenosis; recurrentsinusitis or otitis refractory tomanagement; mass lesion in orbitalcavity with proptosis; destructivenasal mass lesion; andaccompanying renal, pulmonary orother systemic lesions. Hypointenselesions on T2WI of MRI in the headand neck were also highlysuggestive of Wegener'sgranulomatosis. |
本系統中英文摘要資訊取自各篇刊載內容。