CT检查在FESS术前计划制定中的价值

目的:探讨蝶窦与视神经、颈内动脉等邻近结构的CT影像解剖关系,为经蝶窦手术及诊断提供准确的影像解剖学依据。方法:CT扫描病例128例,年龄20～72岁,平均46.2岁;其中男79例,女49例。使用日本TOSHIBA公司生产的Aquilion 4螺旋CT。后台处理采用Vitrea 1处理系统。测量数据采用x±SD,百分数,t检验。结果:视神经管与蝶窦的关系:隆起型视神经管38例(29.69%),压迹型视神经管73例(57.03%),远离型视神经管17例(13.28%)。视神经走行与蝶窦外侧的关系:全程与蝶窦外侧壁毗邻者71侧(27.73%),全程与后组筛窦毗邻者66侧(25.78%),全程同时与蝶筛外侧壁毗邻者95侧(37.11%),全程穿过骨质者22侧(8.59%)。颈内动脉与蝶窦的关系:隆起型48侧(18.75%),压迹型101侧(39.45%),远离型107侧(41.80%)。结论:CT扫描结合MPR重组,能够清楚显示颈内动脉、视神经等与蝶筛外侧壁的解剖毗邻关系。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。

Value of CT examination in plan-making before FESS operation

Objective： To investigate the CT anatomy relation of sphenoid sinus with optical canal, internal carotid artery and other adjacent structures, and provide image anatomic reference for diagnosis and surgery via sphenoidal 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 was collected using Aquilion 4-slice spiral CT made by TOSHIBA, Japan. The data was analyzed with Vitrea 1 system. The results were statistically analyzed utilizing x±SD, percentage, and t-test. Results： The relation between optic canal and sphenoid sinus： there were 38 cases （29.69%）, 73 cases （57.03%）, and 17 cases （13.28%） for prominent, impressed, and separated-away forms of optic canal, respectively. The relation between optic canal and lateral wall of sphenoid sinus： whole course was neighbored in 71 sides （27.73%）, with the posterior ethmoidal sinus neighbored in 66 sides （25. 78%）, and whole course with both sinus neighbored in 95 sides （37.11%）, whole course through the bone in 22 sides （8.59 % ）. The relation between internal carotid artery and sphenoid sinus： prominent in 48 sides （18.75%）, impressed in 101 sides （39.45%）, and separated-away in 107 sides （41.80%）. Conclusion： A combination of CT scanning with muhiplanar reformation can accurately show the relation between sphenoid sinus, optical canal, and internal carotid artery. Therefore, CT can provide impor tant anatomic information for the FESS planning and afford the operation safety.