颞下窝的CT影像与断层标本对照研究及临床意义

目的:为颞下窝病变的影像诊断及手术入路提供解剖学资料.方法:选取志愿者40名,在螺旋CT机上以眦耳线(CML)为基线对颞下窝结构进行层厚1mm连续扫描.选取成人尸体头颈部标本20例,以CML为基线制成层厚5mm连续断层标本.在经冠突和茎突末端层面的CT影像及断层标本上,观察颞下窝及其邻近结构的解剖学关系,测量其长径、宽径和面积.结果:颞下窝的形态呈不规则状,在CT影像和断层标本上经冠突、茎突末端层面的面积分别为(1055.6 +2.05)mm2和(1034.5±3.32) mm2、(356.6±1.78) rm2和(345.8±1.89) mm2.两侧颞下窝及其结构呈对称性,长径、横径和面积侧别间比较差异均无统计学意义(P＞0.05).自茎突至翼突外侧板前缘或翼突内侧板后缘的连线可区分颞下窝与咽旁间隙,茎突、冠突、翼外肌、翼突外侧板和翼突内侧板是CT影像诊断的重要解剖学标志.结论:颞下窝的CT影像与断层标本的解剖对照研究,对颞下窝肿瘤等疾病的影像诊断及指导手术入路具有重要临床意义.

Anatomy Control Study of the Infratemporal Fossa on the CT Imaging and Sectional Specimen and Its Clinical Significance

Objective：To provide anatomical data for imaging diagnosis and surgical approach of infratemporal fossa lesions. Methods ：40 volunteers were selected and scanned in series with 1 mm in thickness by spiral CT from canthomeatal line （CML） of infratemporal fossa. Heads and necks of 20 adult corpses were selected and cut into serial sectional specimen with 5 mm in thickness from the CML. At the CT imaging and sectional specimen of the infratemporal fossa through the coronoid process and the end of styloid process, infratem- poral fossa and its adjacent structures were observed and measured in the length, width and area. Results ：The shape of infratemporal fossa was irregular. At the CT imaging and sectional specimen of the infratemporal fossa through the coronoid process and the end of styloid process, the areas were （ 1055.6 ± 2.05 ）mm2 and （ 1034. 5 ± 3.32） mm2, （ 356.6 ± 1.78 ） mm2 and （345.8 ± 1.89） mm2 in area of the infratemporal fossa respectively. Infratemporal fossa and its structures were symmetrical on both sides, there were no significant differences in the length, width and area. Infratemporal fossa and parapharyngeal space were divided by the line from the styloid process to the lateral or medial pterygoid plate. Styloid process, coronoid process, lateral pterygoid muscle, lateral pterygoid plate and medial pterygoid plate were important anatomical marks for CT imaging diagnosis. Conclusions：CT imaging and sectional specimen study of the infratemporal fossa has an important clinical significance for imaging diagnosis and surgical approach of tumors in the infratemporal fossa.