突入上颌窦的囊性病变85例CT分析

中国口腔颌面外科杂志 ›› 2016, Vol. 14 ›› Issue (4): 332-336.

突入上颌窦的囊性病变85例CT分析

胡颖恺¹, 杨驰¹, 余强², 董敏俊², 徐光宙¹

1.上海交通大学医学院附属第九人民医院·
口腔医学院口腔外科, 上海市口腔医学重点实验室,上海 200011;
2.上海交通大学医学院附属第九人民医院放射科,上海 200011

出版日期:2016-08-20 发布日期:2016-12-08
通讯作者: 杨驰,E-mail:yangchi63@hotmail.com
作者简介:胡颖恺（1990-）,女,硕士研究生,E-mail:1010270262@qq.com
基金资助:
上海市科学技术委员会科研计划项目（14DZ2294300）; 上海市卫生局（原）资助项目（20134102）

Location and differential diagnosis of odontogenic cysts intruding into maxillary sinus

HU Ying-kai¹, YANG Chi¹, YU Qiang², DONG Min-jun², XU Guang-zhou¹

1.Department of Oral Surgery, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine;
Shanghai Key Laboratory of Stomatology. Shanghai 200011;
2.Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011,China

Online:2016-08-20 Published:2016-12-08

摘要/Abstract

摘要： 目的探讨牙源性上颌窦囊性病变部位及其鉴别诊断,以提高术前诊断的准确率,指导手术方案。方法回顾2011年12月—2014年12月就诊于上海交通大学医学院附属第九人民医院口腔外科经螺旋CT诊断为牙源性囊性病变侵及上颌窦的患者,统计上颌窦前外、后、内、下、上5个壁被侵犯的比例。筛选其中有病理诊断者,分析其影像学表现,并结合临床表现进行病种总结和鉴别诊断。结果 85例突入上颌窦的牙源性囊性病变中,侵及上颌窦下壁和后壁者最多。含牙囊肿、根尖囊肿、牙源性角化囊性瘤多见,有2例影像学诊断为成釉细胞瘤,但病理检查为黏液表皮样癌和腺样囊性癌。结论牙源性囊性病变多侵及上颌窦后壁和下壁,需依赖影像、临床表现和病理检查三者结合,以做出准确诊断。

关键词: 上颌窦, 牙源性囊性病变, 螺旋CT, 鉴别诊断

Abstract: PURPOSE: This study was aimed to review the location and differential diagnosis of odontogenic cysts intruding into maxillary sinus, in order to improve accuracy rate of preoperative diagnosis and guide operation planning. METHODS: Cases of odontogenic cysts intruding into sinus diagnosed by spiral CT from 2011.12 to 2014.12 at the Department of Oral Surgery, Shanghai Ninth People’s Hospital were reviewed. The proportion of each sinus wall being invaded was counted using spiral CT images. Then selecting the ones with pathologic diagnosis and analyzing their CT images, along with clinical manifestation to summarize the entities and differential diagnosis of odontogenic cysts. RESULTS: A total of 85 cases were included, the inferior and posterior walls of the sinus were most frequently invaded, and the top three disease entities were dentigerous cyst, radicular cyst and odontogenic keratocystic tumor. Two cases diagnosed as ameloblastoma but turned out to be adenoid cystic carcinoma and mucoepidermoid carcinoma after pathological examination. CONCLUSIONS: Odontogenic cysts often intrudes into inferior and posterior walls of maxillary sinus, diagnosis should depend on CT images and pathological examinations, as well as clinical manifestation.

Key words: Maxillary sinus, Odontogenic cysts, Spiral CT, Differential diagnosis

中图分类号:

R739.8

胡颖恺, 杨驰, 余强, 董敏俊, 徐光宙. 突入上颌窦的囊性病变85例CT分析[J]. 中国口腔颌面外科杂志, 2016, 14(4): 332-336.

HU Ying-kai, YANG Chi, YU Qiang, DONG Min-jun, XU Guang-zhou. Location and differential diagnosis of odontogenic cysts intruding into maxillary sinus[J]. China J Oral Maxillofac Surg, 2016, 14(4): 332-336.

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