上颌窦三维立体形态与上颌窦炎关系的研究

目的:通过螺旋CT影像学研究,重建上颌窦的三维立体形态,探讨上颌窦炎症与上颌窦三维立体形态、容积和气化系数之间的关系。方法:对双侧上颌窦正常者、单侧上颌窦炎症及双侧上颌窦炎症者各50例(均为成年人)行鼻-鼻窦螺旋CT扫描,重建上颌窦的三维立体形态;测量并计算上颌窦的容积和气化系数,分析上颌窦三维立体形态、容积和气化系数与上颌窦炎的关系。结果:上颌窦炎组上颌窦形态不规则(凹陷、变形),容积为(14 971.86±360.93)mm3,气化系数为0.252±0.057;正常组上颌窦形态规则,容积为(15 018.64±473.36)mm3,气化系数为0.345±0.071;两组之间容积比较差异无统计学意义,气化系数比较差异有统计学意义。结论:上颌窦三维重建更加直观地描述了上颌窦的三维结构和立体形态;上颌窦炎症与上颌窦容积无相关性,而主要与上颌窦的三维立体形态及气化系数有关;上颌窦三维立体形态规则,气化系数>0.300,上颌窦发生炎症的概率较低;反之机会增大。成人炎症上颌窦可能来源于儿童及青少年期一个较大的上颌窦。

The relationship between three-dimensional morphology of maxillary sinus and maxillary sinusitis

Objective:A three-dimensional morphology of the maxillary sinus was reconstructed.We studied the relationship between sinusitis and three-dimensional morphology,volume as well as gasification coefficients.Method:One hundred and fifty adult subjects were selected in this study,and divided into three groups: normal bilateral maxillary sinus,unilateral maxillary sinusitis and bilateral maxillary sinusitis,with fifty cases in each group.Use Siemens helix CT for sequential scanning of the nasal-sinus.After scanning,the DICOM data was recorded in DVD-R and transferred into another computer for reconstruction and measurement.Result:The volume of the normal maxillary sinus group was(15 018.64±473.36)mm3.The volume of the maxillary sinusitis group was(14 971.86±360.93)mm3.There was no significant difference between the values of volumes for the normal maxillary sinus group and maxillary sinusitis group.The gasification coefficient was 0.345±0.071 for the normal maxillary sinus group,0.252±0.057 for the maxillary sinusitis group.There was significant difference between the two groups.Conclusion:Maxillary sinus reconstruction permits more vivid visualization of the three-dimensional structure and three-dimensional shape of the maxillary sinus.The occurrence of the maxillary sinusitis is closely related to the three-dimensional shape of the maxillary sinus and the gasification coefficient measured.The more regular the three-dimensional shape of the maxillary sinus,with the gasification coefficient >0.300,the lower the probability of the maxillary sinusitis.Otherwise,the probability increases.Adult inflammation of maxillary sinus may be originated from a relatively larger volume of maxillary sinus in childhood and adolescence.