摘要
目的:为中耳手术中准确定位相关重要解剖结构提供影像解剖依据。方法:收集需行颅底CT扫描的成年人112例(224耳),利用CT多平面重建技术(MPR)重建出轴位和冠状位的图像,定量测量与中耳手术相关的解剖结构间距,比较不同性别和侧别的上述间距测量值,并将测量结果与文献中的尸头和颅骨标本测量值进行比较。结果:不同性别的匙突至水平段面神经距离(C间距)、锥隆起顶点至锥曲段面神经间最短距离(D间距)、面神经隐窝内外径(E间距)及前后径(F间距)、鼓室窦内外径(G间距)及前后径(H间距)、镫骨足板至水平段面神经最短距离(N间距)、镫骨头至水平段面神经最短距离(O间距)差异有统计学意义(P<0.05或P<0.01)。左侧的乙状窦沟前缘至外耳道后壁距离(A间距)、乙状沟底至乳突外表面距离(B间距)、外半规管至颈静脉球最高位置的垂直距离(Q间距)大于右侧,差异有统计学意义(P<0.05)。MPR测量结果与文献中尸头和颅骨标本上所得结果比较,差异均无统计学意义(均P>0.05)。结论:MPR定量测量值可以代表实际中耳解剖结构间距,为手术准确定位及径路选择提供有价值的依据。
Objective： To provide a valuable imaging anatomic method and accurate positioning for operation of tympana. Methods： The clinical information of 112 adult cases （224 sides） was analyzed by CT scanning and three- dimensional image reconstruction of skull base. Axial and coronal images were reconstructed using multiplanar reconstruction （MPR） technique and the anatomic objective structure was displayed by rotating imaging slices. The data were analyzed in statistically and compared with the published cadaver data. Results： There were significant differences in the distance from the chochleariform process to the horizontal portion of facial nerve recess （C）, the shortest distance from the pyramidal eminence to the pyramid segment of the facial canal （D）, inner diameter （E） and outer diameter （F） of facial recess, inner diameter （G） and outer diameter （H） of sinus tympani, the shortest distance from the head of stapes to the horizontal portion of facial nerve recess （N） and the shortest distance from the stapedial footplate to the horizontal portion of facial nerve recess （O） between different genders （P 〈 0.05 or P 〈 0.01）. The left distance from the anterior wall of sigmoid sinus to the posterior wall of extemal auditory meatus （A）, the distance from the lateral wall of sigmoid sinus to the surface of mastoid process （B）, the vertical distance from the lateral semicircular canal to the jugular bulb （Q） were significantly greater than those on the right side （P 〈 0.05）. There were no significant differences between imaging quantitative nt and published cadaver data （P 〉 0.05）. Conclusion： The result of three-dimensional quantitative measurement by using multiplanar reconstruction could represent a real distance of anatomic structures, which may provide a valuable method for surgical approach and accurate positioning Of relative structure in operation.
出处
《天津医药》
CAS
北大核心
2012年第10期1005-1008,I0001,共5页
Tianjin Medical Journal
