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目的:运用多排螺旋CT多层面重组(MPR)技术评价额窦引流通道(FSDP),为前组鼻副窦病变的诊断和鼻内窥镜手术提供实用的影像学信息。方法:回顾分析2008年8~10月在华西医院行鼻部检查50例患者的CT图像资料,其中男24例,女26例,年龄16~62岁,平均37岁。所有病例均行薄层螺旋CT高分辨扫描,扫描平面从硬腭至额窦上缘,准直0.75~1 mm。冠状和平行于筛漏斗方向斜矢状重建,层厚及层距均为1 mm。结果:斜矢状MPR上,共90侧(90.0%)FSDP由上、下两部构成。上部较宽,呈锥形68侧(75.6%),不规则形15侧(16.7%),卵圆形7侧(7.8%);下部窄细,为筛漏斗者36侧(40.0%),中鼻道者53侧(58.9%)。10侧(10.0%)不能分辨FDSP上下两部。冠状MPR上,共见钩突99侧,1侧缺如。钩突附于颅底35侧(35.4%),筛漏斗为FSDP下部;附于筛骨纸板63侧(63.6%),中鼻道为FSDP下部;附于中鼻甲1侧(1.0%),筛漏斗为FSDP下部。钩突气化3侧,其中1侧伴中鼻道变窄。筛泡增大32侧(32.0%),其中8侧(25.0%)伴有筛漏斗和半月裂变窄。双侧钩突附着部位相同者41例(82.0%),不同者8例(16.0%)。结论:多排螺旋CT能良好显示FSDP的结构和形态,为该部位病变的临床诊断和术前计划制定提供有价值的解剖信息。
Objective: To evaluate the frontal sinus drainage channel (FSDP) with multislice spiral computed tomography (MPR) technique and to provide useful imaging information for the diagnosis and nasal endoscopic sinus surgery of anterior sinus lesions. Methods: The CT images of 50 patients with nasal examination in West China Hospital from August to October in 2008 were retrospectively analyzed. There were 24 males and 26 females, aged from 16 to 62 years, with an average of 37 years. All cases underwent thin-slice spiral CT high-resolution scanning, the scan plane from the palate to the frontal sinus margin, alignment 0.75 ~ 1 mm. Coronal and oblique sagittal reconstruction parallel to the direction of the sieve funnel, layer thickness and layer spacing are 1 mm. Results: In oblique sagittal MPR, a total of 90 sides (90.0%) FSDP consists of upper and lower parts. The upper part is broad, conical 68 (75.6%), irregular 15 (16.7%), oval 7 (7.8%); Fifty-three of the nasal passages (58.9%). 10 sides (10.0%) can not distinguish FDSP from top to bottom. Coronal MPR, common to the uncooked 99, 1 missing. The hook was affixed to 35 sides of skull base (35.4%), the funnel was the lower part of FSDP, attached to ethmoidal 63 side (63.6%), the middle part of nasal passages was FSDP, attached to middle turbinate side (1.0%), The funnel is the lower FSDP. Hook gasification 3 sides, of which 1 side with the narrowing of the middle nasal passages. Mesh increased 32 sides (32.0%), of which 8 sides (25.0%) with the sieve funnel and half narrowed. There were 41 cases (82.0%) with identical bilateral unilateral crooked prominences and 8 cases (16.0%) different in all. Conclusion: MSCT can show the structure and morphology of FSDP well and provide valuable anatomic information for the clinical diagnosis and preoperative planning of the lesions.