CT矢状位重建对鼻内窥镜手术相关解剖结构的测量

目的:探讨CT矢状位重建图像上测量与鼻内窥镜手术相关解剖结构对鼻内窥镜手术的参考价值。方法:对66例132侧健康志愿者鼻腔行CT轴位薄层扫描后矢状位重建,以鼻小柱下端外缘为参考点,鼻底为基线,测量与鼻内窥镜手术相关的重要结构与起点的距离及与基线的夹角。结果:所测鼻腔侧壁结构在矢状位重建图像上显示清晰,能准确区分额隐窝、钩突、蝶窦口、前筛顶及其相互关系。鼻小柱至额隐窝的角度和距离分别是(66.1±6.31)°和(52.2±4.55)mm;额隐窝前后径所测值为(5.1±2.72)mm;鼻小柱至前筛顶的角度和距离分别为(62.9±5.75)°和(60.3±5.48)mm;钩突长度为(12.7±3.92)mm;蝶窦口至鼻小柱的距离是(67.0±5.00)mm;准确获得了鼻小柱至鼻腔侧壁与鼻内窥镜手术相关各解剖结构的角度及长度数据。结论:CT鼻腔矢状位重建图像上能准确测量与鼻内窥镜手术相关解剖结构,对了解患者个体差异,减少术中并发症有较大帮助,具有较大的临床价值。

The measurement of anatomy structures related to ESS on CT sagittal reconstruction image

Objective: To discuss the reference value of the measurement of anatomy structures related to endoscopic sinus surgery (ESS) on CT sagittal reconstruction image. Methods: CT thin slice axis images were reconstructed to sagittal images in 132 nasal cavities of 66 volunteers. The angles of basis nasi with important structures of lateral nasal wall and the distance from columella nasi to it were measured on sagittal images. Results: The structures of lateral nasal wall were clearly displayed on sagittal reconstruction image. The main anatomy landmarks were easily identified, such as frontal recess, uncinate process, ostium of sphenoidal sinus and cupula of anteriores ethmoidei sinus. The data of angles and distances from columella nasi to frontal recess, uncinate process, ostium of sphenoidal sinus and cupula of anteriores ethmoidei sinus were accurately obtained. Conclusions: Anatomic structures related to ESS can be accurately measured on CT sagittal reconstruction image. It is helpful for realizing the individual difference and reducing the operation complications during the ESS.