慢性额窦炎额窦引流系统CT解剖特征及临床价值

目的 探讨慢性额窦炎额窦引流系统CT解剖特征及临床价值。方法 对50例慢性鼻窦炎患者应用螺旋CT作横断面扫描，然后经工作站作冠状和矢状面三维重建。结果 螺旋CT三维成像技术能清楚地显示钩突附着部位和类型，在：100侧钩突中，附着纸样板41侧(41％)、鼻丘后壁11侧(11％)、中鼻甲19侧(19％)、前颅底16侧(16％)、钩突分叉13侧(13％)。在额隐窝气房98侧中，终未气房28侧(28．6％)、鼻丘气房18侧(18．4％)、前筛气房18侧(18．4％)。额窦内气房98侧中，其中额气房22侧(22．4％)、眶上气房38侧(38．8％)、额窦中隔气房(M气房)16侧(32％)。发现不同类型的解剖变异与慢性炎症的关系。结论 慢性额窦炎额窦引流系统CT解剖特征的显示可为术前提供有价值的信息，对开展鼻内镜外科有重要的临床指导意义。

CT anatomic features and clinical value of frontal drainage system in chronic frontal sinusitis

Objective To study the anatomic features of frontal drainage system on CT scan in chronic frontal sinusitis, and to evaluate its clinical value. Methods Fifty cases of chronic sinusitis underwent axial MSCT scan with coronal and sagittal 3-dimensional reconstruction. Results 3D reconstructed multislice spiral CT could clearly demonstrate the location and type of uncinate process. Of the 100 sides of uncinate process, it adhered to the lamina papyracea in 41 sides (41%), agger nasi wall in 11 sides (11%), middle turbinate in 19 sides (19%), floor of anterior cranial fossa in 16 sides (16%), and uncinate process furcation in 13 sides (13%). Of the 98 sides of frontal recess cells, terminal cells accounted for 28 sides (28.6%), agger nasi cells in 18 sides (18.4%), and anterior ethmoidal cells in ~18 sides (18.4%). Of the 98 sides of intrafrontal cells, frontal cells accounted for 22 sides (22.4%), superorbital cells in 38 sides (38.8%), and septum of frontal sinus cells (M cells) in 16 sides (32%). The anatomic variations of different types and their relationship with the chronic frontal sinusitis were discovered. Conclusion The demonstration of the anatomic features of frontal sinus district on CT scan in patients with chronic frontal sinusitis can provide detailed image information for endoscopic sinus surgery.