蝶窦开口及内径CT征象与FESS的相关性分析(1)
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【摘要】目的 通过CT扫描，研究蝶窦开口与蝶窦内径CT影像解剖结构，为经蝶窦手术及诊断提供准确的影像学解剖依据。方法 CT扫描病例128例，年龄20-72岁，平均年龄46.2岁，其中男79例，女49例。使用日本TOSHIBA公司生产的Aquilion四螺旋CT(Spiral Computed Tomography，SCT)。后台处理采用Vitrea 1处理系统。应用冠状扫描和轴位扫描，结合MPR(Multiplanar Reformation)重建。测量数据采用 x±SD ，百分数，t检验。结果 ①蝶窦上下径21.6±9.1 mm(32.1-14.2),蝶窦前后径20.3±9.8 mm(31.9-12.8),蝶窦左右径29.9±10.7 mm(37.2-19.7)。②蝶窦分格： 蝶窦内分格者104例(81.3%)，分格可分为左右分格和上下分格，其中两分格者23例(22.1%)，三分格者34例(32.7%)，四分格者18例(17.3%)，五分格者16例(15.4%)，多于6分格 (包括6分格)者13例(12.5%)。③蝶窦开口的形态：蝶窦口通常呈椭圆形，其上下径为2.1±0.3mm(2.5-1.6)，蝶窦口距前鼻棘中点距离59.3±3.9mm(66.2-51.8)。结论 CT冠状位扫描结合MPR重建，能够清楚显示蝶窦开口、蝶窦内径、蝶窦分格及与颈内动脉、视神经等与蝶筛外侧壁的解剖毗邻关系。因此，CT检查有利于FESS手术进路的选择及手术方案的确定，为手术安全提供了保证。
【关键词】蝶窦 螺旋CT FESS
中图分类号：R816.96〓〓〓〓〓〓文献标识码：B〓〓〓〓〓〓文章编号：1005-0515(2011)11-345-03
【ABSTRACT】Objective To study the CT anatomy for the opening and inner diameter of sphenoid sinus, and to provide accurate image anatomic reference for diagnosis and surgery via sphenoid sinus.Methods CT scanning for 128 patients in the age between 20-72 with an average of 46.2.The patients include 79 males and 49 females. The data were collected using Aquilion 4-slice spiral CT made by TOSHIBA, Japan. The data were analyzed with Vitrea 1 system. The coronary and helical CT scanning were applied with multiplanar reformation. The results were express with mean±SD, percentage, and t statistic test. Results (1) the inner diameter of sphenoid sinus for top-down, front-back, and left-right was 21.6±9.1 mm (32.1-14.2), 20.3±9.8 mm (31.9-12.8), and 29.9±10.7 mm (32.7-19.7), respectively. (2) The septation of sphenoid sinus: The septation was found in 104 (81.4%) cases which could be categorized into left-right and top-bottom cavities. The patients were 23 (22.1%), 34 (32.7%), 18 (17.3%), 16 (15.4%), and 13 (12.5%), respectively, with the number of cavities of 2, 3, 4, 5, and 6 and above. (3) The opening shape of sphenoid sinus: The shape is usually oval with a top-bottom diameter of 2 ......
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