颞骨CT三维重建面神经立体解剖定位

目的:探讨基于PC机的颞骨CT三维重建在面神经解剖定位中的方法和应用价值,总结出一套量化的研究面神经定位的方法,以便指导耳科及侧颅底手术。方法:使用3D-DOCTOR软件对成人轴位CT影像进行三维重建,显示颞骨内各重要结构的形态及其相互间复杂的立体关系。并用软件自带的功能测量面神经及其毗邻结构之间的距离和相对角度。分析测得的数据,总结面神经与其毗邻解剖标志结构之间的相对关系。结果:重建获得清晰的三维图像,包括面神经、鼓环、听小骨、匙突、锥隆起、内听道、耳蜗、半规管、颈静脉球窝、颈内动脉管等颞骨内结构。准确测量三维模型所得的面神经及其毗邻结构之间的相关参数并发现一定的规律性,这非常有益于手术中进行面神经快速定位和手术入路的设计。结论:基于PC机的颞骨CT三维重建可以准确地显示其内部各解剖结构及其相互间的空间立体关系,并可进行测量定位。

Quantitative positioning of facial nerve based on three-dimensional CT image reconstruction of temporal bone

Objective:To explore a set of quantitative methods to determine the position of the facial nerve based on three-dimensional CT reconstruction of temporal bone structures on personal computer,which can provide a series of important parameters for ear and the lateral skull base surgery.Method:The internal structures of temporal bone were reconstructed based on a set of axial CT images of adult patients,the complicated relationship and their morphologic characteristics were clearly presented by using Able Software 3D-DOCTOR.The precise measurement of some parameters between facial nerve and its adjacent structures could easily be processed with the software.Based on all obtained data,the relationship of facial nerve and its adjacent structures were effectively summarized and analyzed.Result:Three-dimensional images,including the facial nerve,tympanic anulus,auditory ossicles,chochleariform process,pyramidal eminence,internal auditory,the cochlea,semicircular canal,jugular fossa and carotid artery in the temporal bone,were reconstructed.Some parameters obtained from measuring the distance or angle between the facial nerve and its adjacent structures in the three-dimensional models had some extent regularity,which were benefit to design surgical approach and determine the position of facial nerve during relevant operation.Conclusion:CT 3D reconstruction can accurately display the detailed internal structures anatomy of the temporal bone and their quantitative spatial relationships.