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目的通过应用螺旋CT三维重建定位并描记下颌神经管来指导手术,避免因下颌骨截骨手术损伤下牙槽神经血管束。方法将患者头颈部螺旋CT扫描断层数据输入Mimics医学图像处理软件。行三维重建后cut及s plit工具切除下颌骨外板,于下颌骨髓腔内显露下颌神经管走行后对其进行多点描记,于下颌骨处直观显示下颌神经管走行。将描记下颌神经管走行与三维CT分体重建下颌神经管及下颌曲面断层X线片下颌神经管走行对比,以检验该方法描记下颌神经管走行的准确性。结果本研究共纳入15例患者,均成功于其头面部三维CT图形上描记下颌神经管走行,经与分体重建下颌神经管及下颌曲面断层X线片比对后显示,前者描记下颌神经管走行与后两者显示下颌神经管走行均基本一致。结论应用螺旋CT三维重建模拟下颌外板切除法进行下颌神经管定位方法简单实用,准确性高,可推广于临床。
Objective To guide the operation of the mandibular canal by using three-dimensional reconstruction of spiral CT and tracing the mandibular canal to avoid the damage of the alveolar neurovascular bundle caused by mandibular osteotomy. Methods The CT data of head and neck CT scan were input into Mimics medical image processing software. After three-dimensional reconstruction of the cut and s plit tool removal of the mandibular outer plate, revealed in the mandibular medullary canal of the mandibular canal after its multi-line tracing, the mandibular at the visual display of the mandibular canal running. Tracing the movement of mandibular canal and the three-dimensional CT split reconstruction of mandibular canal and mandibular surface of the X-ray films were compared to determine the accuracy of the method. Results A total of 15 patients were enrolled in this study. All of them succeeded in tracing the three-dimensional CT images of the mandibular surface. The alignment of the mandibular canal with the reconstruction of the mandibular canal and the mandibular surface showed that the former was able to record the mandibular canal Walking and the latter two showed that the movement of mandibular neural tube are basically the same. Conclusion The application of spiral CT three-dimensional reconstruction to simulate the mandibular external plate excision for the localization of mandibular canal is simple and practical, with high accuracy and can be generalized in clinical practice.