多排螺旋CT面神经管重建及其在面神经麻痹诊断中的应用价值

目的探讨多排螺旋CT对面神经管显示能力及其在周围性面神经麻痹诊断中的应用价值。方法应用图像重建技术对43例患者面神经管进行多平面重建（MPR）及曲面重建（CPR），并对面神经管各段及第一弯曲、第二弯曲进行测量。结果在43例中发现：颈静脉球增大面神经管骨质缺损1例；先天性外耳道闭锁1例；急慢性中耳炎15例17耳，9耳面神经管有破坏，引起面神经麻痹者仅1耳；本组面神经管裂缺发生率为86％（37／43）。面神经管CPR及MPR图像能清楚地显示面神经各段，CPR能够在同一幅图像上显示双侧面神经管全貌，MPR与CPR的测量结果基本一致，但部分不一致；面神经麻痹患者健侧及患侧的测量值比较无统计学差异（P〉0．05）。结论面神经管MPR及CPR图像相结合是研究面神经管解剖的良好影像学方法，能给临床医生在诊断面神经管发育异常、肿瘤、慢性中耳炎等提供有力的证据。

Multislice helical CT reformation imaging of facial nerve canal and its application for diagnosing facial paralysis

Objective To study the value of multislice helical CT multiplanar reformation to the display of facial nerve canal and the diagnosing of facial paralysis.Methods Multislice CT with multiplanar reformation(MPR) and curved planar reformation(CPR) were performed in 43 ENT cases,including 13 cases of facial paralysis,14 chronic otitis media,1 facial nerve canal defect secondary to large jugular bulb,1 congenital outer ear abnormality,and 14 cases of other illnesses.The facial nerve canal was surveyed on CPR and MPR by segments.Results Amang the 43 ENT cases,enlargement of bulbus venae jugularis with deossification of facial nerve canal was found in 1 case,congenital atresia of external auditory canal in 1 case,acute or chronic otitis media in 15 cases(17 ears),facial nerve canal lesion in 9 ears in which only 1 ear with facial paralysis.The incidence of facial nerve canal coloboma was 86%(37/43).The facial nerve canal could be clearly displayed segment by segment.Using CPR,bilateral facial nerve canals could be displayed in one image.The anatomical data of facial nerve canals obtained from MPR were essentially in agreement with those from CPR,with occasional exceptions.No significant structural differences were found between the affected and healthy sides in patients with facial paralysis(P>0.05).Conclusion Multislice helical CT CPR and MPR are useful to the imaging study of the facial nerve canal,providing clinicians with valuable information concerning anatomic variations,congenital malformations,tumors and otitis meia.