摘要
目的:采用多层螺旋CT技术研究蝶窦后壁的可开窗范围,并分析其相关的限制因素。方法:对110例头部增强薄层CT扫描的原始资料行多平面重建,测量双侧颈内动脉外侧襻间距和内侧襻间距、蝶窦后壁面积、蝶窦后壁骨质厚度等数据,观察并记录蝶窦的位置和气化、蝶窦分隔、颈内动脉有无突入窦腔情况及斜坡处静脉窦强化等表现。结果:结合蝶窦气化情况,将蝶窦后壁按厚度分为厚壁型(35．6%)、薄壁型(55．9%)及菲薄型(8．5%)。两侧颈内动脉的外侧襻间距(19．2±2．9)mm、内侧襻间距(15．8±2．3)mm限定了蝶窦后壁可开窗的边界。蝶窦后壁的可开窗面积平均为(251．0±53．1)mm^2。结论:蝶窦后壁整体上可形成类梯形窗口。开放窗口的主要限制因素有双侧颈内动脉间距、蝶窦后壁骨质厚度及斜坡处静脉窦。CT重建和测量可显示蝶窦腔内、外的关键结构,对经蝶手术的术前评价和计划具重要意义。
Objective To study the extent of operation window in the posterior wall of the sphenoidal sinus for endoscopic surgery using the multi-slice computed tomography （MSCT）. Methods Computed tomography images of the cranial base of 110 adults were reformatted to measure the distances of two sides of the lateral internal carotid loops and of the interior loops, the potential area and the thickness of the operation window in the posterior wall of the sphenoidal sinus. Results According to the location and pneumatization of the sphenoidal sinus, 110 posterior walls of sphenoidal sinus were assigned into three categories： thick walls（35.6%）, thin walls（55.9%） and weak walls（8.5%）. The potential operation window in the posterior wall of the sphenoidal sinus, the mean area of which was （251±53.1）mm^2, was bounded by the lateral and the interior loops of internal carotid. The distances of the lateral and the interior loops of internal carotid were （19.2±2.9）mm,and （15.8＋2.3）mm, respectively. Conclusions The trapezoid window could be formed in the posterior wall of sphenoidal cell. The mainly limited factors in operative approach in the posterior wall of the sphenoidal sinus are the thickness of the posterior sclerotic wall, the confines of the internal carotid and the venous sinus behind the elivus. MSCT with the image reconstruction can help the surgeon make a decision.
出处
《诊断学理论与实践》
2007年第1期26-29,共4页
Journal of Diagnostics Concepts & Practice
关键词
蝶窦
斜坡
多层螺旋CT
形态学测量
图像重建
Transsphenoidal approach
Clivus
Multi-slice computed tomography
Morphological measurement
