慢性鼻窦炎(chronic rhinosinusitis,CRS)是耳鼻咽喉头颈外科的常见病,其病因学及病理生理机制复杂。在过去的10年中,我国在"南昌指南"(2008)基础上修订的"昆明指南"(2012),既借鉴了欧洲鼻窦炎和鼻息肉意见书(Europ...慢性鼻窦炎(chronic rhinosinusitis,CRS)是耳鼻咽喉头颈外科的常见病,其病因学及病理生理机制复杂。在过去的10年中,我国在"南昌指南"(2008)基础上修订的"昆明指南"(2012),既借鉴了欧洲鼻窦炎和鼻息肉意见书(European position paper on rhinosinusitis and nasal polyps,EPOS)2012年版的内容,又参考了我国临床实践的相关研究成果,具有较好的实用性,对规范和推动我国CRS的临床诊疗起到了重要的引导作用。展开更多
Objective:To compare and correlate the efficacy of the NOSE score&the VAS score in determining the symptomatic benefit in patients undergoing septoplasty.Materials and methods:Eighty patients with deviated nasal s...Objective:To compare and correlate the efficacy of the NOSE score&the VAS score in determining the symptomatic benefit in patients undergoing septoplasty.Materials and methods:Eighty patients with deviated nasal septum undergoing septoplasty were included in the study.NOSE score&VAS score(out of 100)was documented before and after surgery.Results were correlated and compared statistically.Results:In the NOSE score,the most bothersome symptom was trouble breathing through the nose(85.83);followed by Nasal obstruction or blockage(82.50).Wilcoxon test showed significant improvement with NOSE score and VAS score in all patients at 1 month and 3 months.Spearman’s coefficient showed a positive correlation between the two,though the score improvement and patient satisfaction rate was significantly high with NOSE score.Conclusions:NOSE score and the VAS score both provide effective framework for evaluating treatment responses after septoplasty.However,the NOSE score showed higher improvement and better patient satisfaction rate when used to measure of nasal obstruction as compared to the VAS score.展开更多
Chronic rhinosinusitis(CRS) is a common disease worldwide, with a prevalence rate of 5%-15% in the general population. CRS is currently classified into two types: CRS with and without nasal polyps. CRS may also be div...Chronic rhinosinusitis(CRS) is a common disease worldwide, with a prevalence rate of 5%-15% in the general population. CRS is currently classified into two types: CRS with and without nasal polyps. CRS may also be divided into eosinophilic CRS(ECRS) and non-ECRS subtypes based on the presence of tissue eosinophilic infiltration or not. There are significant geographic and ethnic differences in the tissue eosinophilic infiltration, which is predominant in Western white patients and less common in East Asians, despite an increasing tendency for its prevalence in East Asia countries. ECRS differs significantly from non-ECRS in clinical characteristics, treatment outcomes and strategies, and underlying pathogenic mechanisms. ECRS commonly demonstrates more severe symptoms, polyp diseases with a higher incidence of bilateral polyps and sinonasal diseases on computed tomography, and the increase in blood eosinophils. ECRS is considered a special and recalcitrant subtype of CRS, commonly with poor treatment outcomes compared to non-ECRS. The differentiation of specific subtypes and clinical features of CRS will be important for developing novel treatment strategies and improving treatment outcomes for individual phenotypes of CRS. This review discusses clinical features, diagnosis, treatment and prognosis of ECRS in East Asians.展开更多
Background The inferior turbinate （IT） and nasolacrimal duct （NLD） are often sacrificed while managing the diffuse lesion of maxillary sinus （MS）. We report a new approach to MS without ablation of NLD and IT. M...Background The inferior turbinate （IT） and nasolacrimal duct （NLD） are often sacrificed while managing the diffuse lesion of maxillary sinus （MS）. We report a new approach to MS without ablation of NLD and IT. Methods This retrospective study enrolled 19 hospitalized patients （aged from 42 to 68 years） who underwent endoscopic sinus surgery between 2003 and 2008. Twelve patients had inverted papilloma （IP）, two had nasal polyps, two had Kubo＇s postoperative cyst of MS, one had recurrent bone cyst of maxilla, one had dentigerous cyst and one had bleeding of internal maxillary artery secondary to CaldwelI-Luc operation respectively. Two IP patients were excluded from this group since the follow-up time was less than 12 months. The NLD was dissected after removing the anterior bony portion of nasal lateral wall. The prelacrimal recess approach （PLRA） to MS was established when IT-NLD flap was raised medially. The flap was repositioned when MS lesion was removed. Results All the 17 patients had unilateral lesions. Ten MS IP patients were at the T3 Krouse stage. The follow-up ranged from 7 to 60 months. No recurrence was seen in 16 patients. Only one IP patient had a local recurrence in MS. All of them had no any complications. Conclusion The diffuse or severe diseases of MS may be the potential indications for PLRA.展开更多
变应性鼻炎是严重影响患者生活质量，加重社会经济负担的全球性健康问题。众多国家和地区对变应性鼻炎的流行病学特点进行了多种调查。在美国，一项有关变应性鼻炎流行病学调查的最新结果：美国变应性鼻炎调查报告（Allergies in Americ...变应性鼻炎是严重影响患者生活质量，加重社会经济负担的全球性健康问题。众多国家和地区对变应性鼻炎的流行病学特点进行了多种调查。在美国，一项有关变应性鼻炎流行病学调查的最新结果：美国变应性鼻炎调查报告（Allergies in America：A Landmark Survey of Nasal Allergy Suffers）于2006-12-11公布。与其他调查相比，该调查不仅对患者的症状和生活质量进行了研究，还特别对患者的用药及疗效进行了调查，展开更多
Objective To improve the closure rate of large nasal septal perforations. Methods Using an endoscope, complex mucoperichondrial/mucoperiosteal flaps on one side and free tissue graft on the other, we designed a proc...Objective To improve the closure rate of large nasal septal perforations. Methods Using an endoscope, complex mucoperichondrial/mucoperiosteal flaps on one side and free tissue graft on the other, we designed a procedure to repair large nasal septal perforations.Results In our series, 8 patients were operated on with this procedure, resulting in complete closure of the perforation and subsequent relief of symptoms. Conclusion This technique may be used as an alter?native for the repair of large nasal septal perforations.展开更多
BACKGROUND Hypoxemia due to respiratory depression and airway obstruction during upper gastrointestinal endoscopy with sedation is a common concern.The Wei nasal jet tube(WNJT)is a new nasopharyngeal airway with the a...BACKGROUND Hypoxemia due to respiratory depression and airway obstruction during upper gastrointestinal endoscopy with sedation is a common concern.The Wei nasal jet tube(WNJT)is a new nasopharyngeal airway with the ability to provide supraglottic jet ventilation and oxygen insufflation via its built-in wall channel.The available evidence indicates that with a low oxygen flow,compared with nasal cannula,the WNJT does not decrease the occurrence of hypoxemia during upper gastrointestinal endoscopy with propofol sedation.To date,there has been no study assessing the performance of WNJT for supplemental oxygen during upper gastrointestinal endoscopy with sedation when a moderate oxygen flow is used.AIM To determine whether the WNJT performs better than the nasal prongs for the prevention of hypoxemia during gastroscopy with propofol mono-sedation when a moderate oxygen flow is provided in patients with a normal body mass index.METHODS This study was performed in 291 patients undergoing elective gastroscopy with propofol mono-sedation.Patients were randomized into one of two groups to receive either the WNJT(WNJT group,n=147)or the nasal cannula(nasal cannula group,n=144)for supplemental oxygen at a 5-L/min flow during gastroscopy.The lowest SpO2 during gastroscopy was recorded.The primary endpoint was the incidence of hypoxemia or severe hypoxemia during gastroscopy.RESULTS The total incidence of hypoxemia and severe hypoxemia during gastroscopy was significantly decreased in the WNJT group compared with the nasal cannula group(P=0.000).The lowest median SpO2 during gastroscopy was significantly higher(98%;interquartile range,97-99)in the WNJT group than in the nasal cannula group(96%;interquartile range,93-98).Epistaxis by device insertion in the WNJT group occurred in 7 patients but stopped naturally without any treatment.The two groups were comparable in terms of the satisfaction of physicians,anesthetists and patients.CONCLUSION With a moderate oxygen flow,the WNJT is more effective for the prevention of hypoxem展开更多
Background Malignant sinonasal melanoma （MSM） is a rare tumor with a perplexing signal intensity due to variable histopathologic components. This study was undertaken to delineate its MR imaging features. Methods MR...Background Malignant sinonasal melanoma （MSM） is a rare tumor with a perplexing signal intensity due to variable histopathologic components. This study was undertaken to delineate its MR imaging features. Methods MR imaging findings of 10 patients （6 women and 4 men, mean age 61.3 years old） with pathologically confirmed MSM were retrospectively reviewed. The location, size, signal intensity, enhancement, and internal imaging characteristics of all tumors were evaluated. Signal intensity and degree of enhancement was graded in comparison with the gray matter and adjacent muscle uptake, respectively. Results There were 8 tumors that were pathologically confirmed to contain melanin. Compared to gray matter of the brain, 7 of them demonstrated hyperintensity on T1WI and 6 （6/7） showed hypointensity on T2Wl. There was multiple linear, dark-signal intensity on T2Wl within the mass in 9 of the 10 patients＇ tumors. Evaluated with gadolinium-enhanced imaging, all 10 patients showed moderate enhancement within the areas that were isointense in the lesion on pregadolinium TlWl. Moreover, some parts which displayed hyperintensity on TlWl within the tumors of 7 patients showed mild enhancement that was similar to muscle on a time-intensity curve （TIC）. Conclusions MSM shows characteristic MR signal intensity （hyperintensity on TlWl and the linear, low-signal intensity on T2Wl）, which may provide valuable information for clinical diagnosis. Together with conventional MRI, TIC may be useful for indicating pleomorphic patterns of MSM.展开更多
Background Distinguishing inverted papilloma （IP） from malignant tumors in the nasal cavity is difficult in a substantial number of cases,thus hindering the administration of appropriate therapeutic strategies.This ...Background Distinguishing inverted papilloma （IP） from malignant tumors in the nasal cavity is difficult in a substantial number of cases,thus hindering the administration of appropriate therapeutic strategies.This study aimed to evaluate whether magnetic resonance imaging （MRI）,including dynamic contrast enhanced MRI （DCE-MRI）,could improve differentiation between IP and malignant tumors,and to identify which MRI features were the best in discriminating IP from malignant tumors in the nasal cavity.Methods Non-enhanced,static,and dynamic contrast enhanced MRI was performed in 88 patients with an IP or a malignant tumor in the nasal cavity that had been confirmed by histological results.MRI features of IP and malignant tumors including side,margin,T1 signal intensity,T1 homogeneity,T2 signal intensity,T2 homogeneity,lobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,pattern of enhancement,Tpeak,Tmax,Clmax,and TIC type were evaluated and correlated with histological findings.Results There were significant differences between IP and malignant tumors in T2 homogeneity,Iobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,Tpeak,Tmax and TIC types.A convoluted cerebriform pattern had a higher sensitivity and specificity in diagnosis of IP while washout-type TIC had a higher sensitivity and specificity in diagnosis of malignant tumors in the nasal cavity.Non-enhanced combined with static and dynamic enhancement MRI was significantly superior to non-enhanced combined with static enhancement MRI in the differentiation of IP and malignant tumors in the nasal cavity.Multivariate logistic regression analysis identified that the best MRI features were a convoluted cerebriform pattern,extra-sinonasal involvement,and washout-type TIC for both observers （Wang XY and Zhang ZY）.Conclusion Non-enhanced and static combined with dynamic contrast-enhanced MRI improves differentiation of IP and malignant tumors in the nasal cavity.展开更多
Background Quantitative dynamic contrast enhancement MR imaging （DCE-MRI）,used to measure properties of tissue microvasculature and tumor angiogenesis,is a promising method for distinguishing benign and malignant tu...Background Quantitative dynamic contrast enhancement MR imaging （DCE-MRI）,used to measure properties of tissue microvasculature and tumor angiogenesis,is a promising method for distinguishing benign and malignant tumors and characterizing tumor response to antiangiogenic treatment.The aim of this study was to assess the feasibility of quantitative parameters derived from clinically used DCE-MRI for distinguishing benign from malignant tumors in the sinonasal area,which may be potentially useful for prediction and monitoring of treatment response to chemoradiotherapy of sinonasal tumors.Methods One hundred and forty-three patients with sinonasal tumors,including 78 malignant tumors and 65 benign tumors and tumor-like lesions,underwent clinically used DCE-MRI.Parametric maps were obtained for quantitative parameters including Ktrans,kep and ve.Two radiologists reviewed these maps and measured Ktrans,kep and ve in the tumor tissue.Data were analyzed using independent T-test or Mann-Whitney U test analysis and receiver operating characteristic curves.Results Ktrans,kep and ve showed significant differences between benign and malignant tumors in the sinonasal area （P=-0.000 1）.The accuracy of Ktrans,kep and ve in differentiation between benign and malignant sinonasal tumors were 72.0％,76.2％ and 67.1％,respectively.There were significant differences in kep and ve between malignant epithelial sinonasal tumors and lymphomas （P ＜0.05）.Using a ve value of 0.213 as the threshold value differentiated malignant epithelial tumors from lymphomas with an accuracy of 78.3％,sensitivity of 88.2％,specificity of 68.0％,positive predictive value of 66.7％,and negative predictive value of 90.9％.However,no significant difference in Ktrans and kep was found between malignant epithelial and non-epithelial tumors in the sinonasal area （P ＞0.05）.Conclusions It is feasible that quantitative parameters of tumors can be derived from clinically used DCE-MRI in the sinonasal region.Preliminary findings suggest an展开更多
慢性鼻．鼻窦炎（CRS）和鼻息肉是一组多因素导致、多步骤发生的、具有高度异质性的鼻黏膜炎性病变，尽管过去20年间相关研究取得了巨大进展，但仍有很多重要的诊疗问题没有获得专家学者们的一致认识[1]。2007年，由荷兰鼻科专家Fokken...慢性鼻．鼻窦炎（CRS）和鼻息肉是一组多因素导致、多步骤发生的、具有高度异质性的鼻黏膜炎性病变，尽管过去20年间相关研究取得了巨大进展，但仍有很多重要的诊疗问题没有获得专家学者们的一致认识[1]。2007年，由荷兰鼻科专家Fokkens等牵头组织的国际专家组依据循证医学的原则对2005年CRS和鼻息肉的诊疗文件进行了整理和补充，随后在Rhinology杂志以增刊的形式刊发了该立场文件，即2007版的欧洲CRS和鼻息肉意见（European position paper on rhinosinusitis and nasal polyps 2007，EPOS2007）旧[2]。展开更多
文摘慢性鼻窦炎(chronic rhinosinusitis,CRS)是耳鼻咽喉头颈外科的常见病,其病因学及病理生理机制复杂。在过去的10年中,我国在"南昌指南"(2008)基础上修订的"昆明指南"(2012),既借鉴了欧洲鼻窦炎和鼻息肉意见书(European position paper on rhinosinusitis and nasal polyps,EPOS)2012年版的内容,又参考了我国临床实践的相关研究成果,具有较好的实用性,对规范和推动我国CRS的临床诊疗起到了重要的引导作用。
文摘Objective:To compare and correlate the efficacy of the NOSE score&the VAS score in determining the symptomatic benefit in patients undergoing septoplasty.Materials and methods:Eighty patients with deviated nasal septum undergoing septoplasty were included in the study.NOSE score&VAS score(out of 100)was documented before and after surgery.Results were correlated and compared statistically.Results:In the NOSE score,the most bothersome symptom was trouble breathing through the nose(85.83);followed by Nasal obstruction or blockage(82.50).Wilcoxon test showed significant improvement with NOSE score and VAS score in all patients at 1 month and 3 months.Spearman’s coefficient showed a positive correlation between the two,though the score improvement and patient satisfaction rate was significantly high with NOSE score.Conclusions:NOSE score and the VAS score both provide effective framework for evaluating treatment responses after septoplasty.However,the NOSE score showed higher improvement and better patient satisfaction rate when used to measure of nasal obstruction as compared to the VAS score.
文摘Chronic rhinosinusitis(CRS) is a common disease worldwide, with a prevalence rate of 5%-15% in the general population. CRS is currently classified into two types: CRS with and without nasal polyps. CRS may also be divided into eosinophilic CRS(ECRS) and non-ECRS subtypes based on the presence of tissue eosinophilic infiltration or not. There are significant geographic and ethnic differences in the tissue eosinophilic infiltration, which is predominant in Western white patients and less common in East Asians, despite an increasing tendency for its prevalence in East Asia countries. ECRS differs significantly from non-ECRS in clinical characteristics, treatment outcomes and strategies, and underlying pathogenic mechanisms. ECRS commonly demonstrates more severe symptoms, polyp diseases with a higher incidence of bilateral polyps and sinonasal diseases on computed tomography, and the increase in blood eosinophils. ECRS is considered a special and recalcitrant subtype of CRS, commonly with poor treatment outcomes compared to non-ECRS. The differentiation of specific subtypes and clinical features of CRS will be important for developing novel treatment strategies and improving treatment outcomes for individual phenotypes of CRS. This review discusses clinical features, diagnosis, treatment and prognosis of ECRS in East Asians.
文摘Background The inferior turbinate （IT） and nasolacrimal duct （NLD） are often sacrificed while managing the diffuse lesion of maxillary sinus （MS）. We report a new approach to MS without ablation of NLD and IT. Methods This retrospective study enrolled 19 hospitalized patients （aged from 42 to 68 years） who underwent endoscopic sinus surgery between 2003 and 2008. Twelve patients had inverted papilloma （IP）, two had nasal polyps, two had Kubo＇s postoperative cyst of MS, one had recurrent bone cyst of maxilla, one had dentigerous cyst and one had bleeding of internal maxillary artery secondary to CaldwelI-Luc operation respectively. Two IP patients were excluded from this group since the follow-up time was less than 12 months. The NLD was dissected after removing the anterior bony portion of nasal lateral wall. The prelacrimal recess approach （PLRA） to MS was established when IT-NLD flap was raised medially. The flap was repositioned when MS lesion was removed. Results All the 17 patients had unilateral lesions. Ten MS IP patients were at the T3 Krouse stage. The follow-up ranged from 7 to 60 months. No recurrence was seen in 16 patients. Only one IP patient had a local recurrence in MS. All of them had no any complications. Conclusion The diffuse or severe diseases of MS may be the potential indications for PLRA.
文摘变应性鼻炎是严重影响患者生活质量，加重社会经济负担的全球性健康问题。众多国家和地区对变应性鼻炎的流行病学特点进行了多种调查。在美国，一项有关变应性鼻炎流行病学调查的最新结果：美国变应性鼻炎调查报告（Allergies in America：A Landmark Survey of Nasal Allergy Suffers）于2006-12-11公布。与其他调查相比，该调查不仅对患者的症状和生活质量进行了研究，还特别对患者的用药及疗效进行了调查，
文摘Objective To improve the closure rate of large nasal septal perforations. Methods Using an endoscope, complex mucoperichondrial/mucoperiosteal flaps on one side and free tissue graft on the other, we designed a procedure to repair large nasal septal perforations.Results In our series, 8 patients were operated on with this procedure, resulting in complete closure of the perforation and subsequent relief of symptoms. Conclusion This technique may be used as an alter?native for the repair of large nasal septal perforations.
基金Supported by“Renfu”Research Fund by Chinese Society of Digestive Endoscopy,No.CSDE012017120006.
文摘BACKGROUND Hypoxemia due to respiratory depression and airway obstruction during upper gastrointestinal endoscopy with sedation is a common concern.The Wei nasal jet tube(WNJT)is a new nasopharyngeal airway with the ability to provide supraglottic jet ventilation and oxygen insufflation via its built-in wall channel.The available evidence indicates that with a low oxygen flow,compared with nasal cannula,the WNJT does not decrease the occurrence of hypoxemia during upper gastrointestinal endoscopy with propofol sedation.To date,there has been no study assessing the performance of WNJT for supplemental oxygen during upper gastrointestinal endoscopy with sedation when a moderate oxygen flow is used.AIM To determine whether the WNJT performs better than the nasal prongs for the prevention of hypoxemia during gastroscopy with propofol mono-sedation when a moderate oxygen flow is provided in patients with a normal body mass index.METHODS This study was performed in 291 patients undergoing elective gastroscopy with propofol mono-sedation.Patients were randomized into one of two groups to receive either the WNJT(WNJT group,n=147)or the nasal cannula(nasal cannula group,n=144)for supplemental oxygen at a 5-L/min flow during gastroscopy.The lowest SpO2 during gastroscopy was recorded.The primary endpoint was the incidence of hypoxemia or severe hypoxemia during gastroscopy.RESULTS The total incidence of hypoxemia and severe hypoxemia during gastroscopy was significantly decreased in the WNJT group compared with the nasal cannula group(P=0.000).The lowest median SpO2 during gastroscopy was significantly higher(98%;interquartile range,97-99)in the WNJT group than in the nasal cannula group(96%;interquartile range,93-98).Epistaxis by device insertion in the WNJT group occurred in 7 patients but stopped naturally without any treatment.The two groups were comparable in terms of the satisfaction of physicians,anesthetists and patients.CONCLUSION With a moderate oxygen flow,the WNJT is more effective for the prevention of hypoxem
基金This study was tSnancally supported by the China Postdoctoral Science Foundation （No. 20090461433）, and the National Natural Science Foundation of China （No. 30900352）.
文摘Background Malignant sinonasal melanoma （MSM） is a rare tumor with a perplexing signal intensity due to variable histopathologic components. This study was undertaken to delineate its MR imaging features. Methods MR imaging findings of 10 patients （6 women and 4 men, mean age 61.3 years old） with pathologically confirmed MSM were retrospectively reviewed. The location, size, signal intensity, enhancement, and internal imaging characteristics of all tumors were evaluated. Signal intensity and degree of enhancement was graded in comparison with the gray matter and adjacent muscle uptake, respectively. Results There were 8 tumors that were pathologically confirmed to contain melanin. Compared to gray matter of the brain, 7 of them demonstrated hyperintensity on T1WI and 6 （6/7） showed hypointensity on T2Wl. There was multiple linear, dark-signal intensity on T2Wl within the mass in 9 of the 10 patients＇ tumors. Evaluated with gadolinium-enhanced imaging, all 10 patients showed moderate enhancement within the areas that were isointense in the lesion on pregadolinium TlWl. Moreover, some parts which displayed hyperintensity on TlWl within the tumors of 7 patients showed mild enhancement that was similar to muscle on a time-intensity curve （TIC）. Conclusions MSM shows characteristic MR signal intensity （hyperintensity on TlWl and the linear, low-signal intensity on T2Wl）, which may provide valuable information for clinical diagnosis. Together with conventional MRI, TIC may be useful for indicating pleomorphic patterns of MSM.
基金This work was supported by Beijing Excellent Talents Foundation （No. 2010D003034000033）, Beijing Municipal Natural Science Foundation （No. 7112030）, and High Levels of Health Technical Personnel in Beijing City （No. 2011-3-047）.
文摘Background Distinguishing inverted papilloma （IP） from malignant tumors in the nasal cavity is difficult in a substantial number of cases,thus hindering the administration of appropriate therapeutic strategies.This study aimed to evaluate whether magnetic resonance imaging （MRI）,including dynamic contrast enhanced MRI （DCE-MRI）,could improve differentiation between IP and malignant tumors,and to identify which MRI features were the best in discriminating IP from malignant tumors in the nasal cavity.Methods Non-enhanced,static,and dynamic contrast enhanced MRI was performed in 88 patients with an IP or a malignant tumor in the nasal cavity that had been confirmed by histological results.MRI features of IP and malignant tumors including side,margin,T1 signal intensity,T1 homogeneity,T2 signal intensity,T2 homogeneity,lobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,pattern of enhancement,Tpeak,Tmax,Clmax,and TIC type were evaluated and correlated with histological findings.Results There were significant differences between IP and malignant tumors in T2 homogeneity,Iobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,Tpeak,Tmax and TIC types.A convoluted cerebriform pattern had a higher sensitivity and specificity in diagnosis of IP while washout-type TIC had a higher sensitivity and specificity in diagnosis of malignant tumors in the nasal cavity.Non-enhanced combined with static and dynamic enhancement MRI was significantly superior to non-enhanced combined with static enhancement MRI in the differentiation of IP and malignant tumors in the nasal cavity.Multivariate logistic regression analysis identified that the best MRI features were a convoluted cerebriform pattern,extra-sinonasal involvement,and washout-type TIC for both observers （Wang XY and Zhang ZY）.Conclusion Non-enhanced and static combined with dynamic contrast-enhanced MRI improves differentiation of IP and malignant tumors in the nasal cavity.
基金This work was supported by grants from Beijing Excellent Talents Foundation （No.2010D003034000033）,Beijing Municipal Natural Science Foundation （No.7112030）,High Levels of Health Technical Personnel in Beijing City （No.2011-3-047） and China Postdoctoral Science Foundation （No.2011M500026）.
文摘Background Quantitative dynamic contrast enhancement MR imaging （DCE-MRI）,used to measure properties of tissue microvasculature and tumor angiogenesis,is a promising method for distinguishing benign and malignant tumors and characterizing tumor response to antiangiogenic treatment.The aim of this study was to assess the feasibility of quantitative parameters derived from clinically used DCE-MRI for distinguishing benign from malignant tumors in the sinonasal area,which may be potentially useful for prediction and monitoring of treatment response to chemoradiotherapy of sinonasal tumors.Methods One hundred and forty-three patients with sinonasal tumors,including 78 malignant tumors and 65 benign tumors and tumor-like lesions,underwent clinically used DCE-MRI.Parametric maps were obtained for quantitative parameters including Ktrans,kep and ve.Two radiologists reviewed these maps and measured Ktrans,kep and ve in the tumor tissue.Data were analyzed using independent T-test or Mann-Whitney U test analysis and receiver operating characteristic curves.Results Ktrans,kep and ve showed significant differences between benign and malignant tumors in the sinonasal area （P=-0.000 1）.The accuracy of Ktrans,kep and ve in differentiation between benign and malignant sinonasal tumors were 72.0％,76.2％ and 67.1％,respectively.There were significant differences in kep and ve between malignant epithelial sinonasal tumors and lymphomas （P ＜0.05）.Using a ve value of 0.213 as the threshold value differentiated malignant epithelial tumors from lymphomas with an accuracy of 78.3％,sensitivity of 88.2％,specificity of 68.0％,positive predictive value of 66.7％,and negative predictive value of 90.9％.However,no significant difference in Ktrans and kep was found between malignant epithelial and non-epithelial tumors in the sinonasal area （P ＞0.05）.Conclusions It is feasible that quantitative parameters of tumors can be derived from clinically used DCE-MRI in the sinonasal region.Preliminary findings suggest an
文摘慢性鼻．鼻窦炎（CRS）和鼻息肉是一组多因素导致、多步骤发生的、具有高度异质性的鼻黏膜炎性病变，尽管过去20年间相关研究取得了巨大进展，但仍有很多重要的诊疗问题没有获得专家学者们的一致认识[1]。2007年，由荷兰鼻科专家Fokkens等牵头组织的国际专家组依据循证医学的原则对2005年CRS和鼻息肉的诊疗文件进行了整理和补充，随后在Rhinology杂志以增刊的形式刊发了该立场文件，即2007版的欧洲CRS和鼻息肉意见（European position paper on rhinosinusitis and nasal polyps 2007，EPOS2007）旧[2]。
