额窦引流通道及额隐窝气房的CT影像分型及临床应用价值研究

目的　探讨CT影像上额窦引流通道的解剖分型及额隐窝气房的分布特征，了解其与额窦炎症发生的关系。 方法　对1355例病人鼻窦CT薄层扫描及多平面重建图像进行解剖学观察及额窦炎诊断。对于气化额窦，按钩突附着部位分型：附着于眼眶侧壁、筛板及颅底分别为额窦引流通道I型、II型和III型；观察额隐窝气房的解剖特征及变异情况，并依据国际额窦解剖分型（IFAC）对其进行分类。 结果　本组1355例中，气化额窦2582侧，额窦炎456例，II型、III型额窦引流通道其额窦炎发生率较高，I型与II型、III型比较有统计学差异（P<0.05），II型与III型之间无统计学差异（P>0.05）。鼻丘气房（ANC）、筛泡上气房（SBC）为“常驻气房”，炎症发生率与平均额窦炎症发生率相近，其余类型额隐窝气房炎症发生率相对于平均额窦炎症发生率均有统计学意义（P<0.05）。 结论　额窦引流通道的变异及额窦周围各型气房气化情况对于额窦炎症发生都有重要影响，高分辨率CT扫描及多平面重建可清晰反映额窦的引流通道变异及额窦周围各型气房解剖情况。

The classification and clinical application of frontal sinus drainage channel and frontal crypt air chamber in CT imaging

Objective　To understand occurrence of frontal sinus inflammation by investigating the imaging of 64 slice spiral CT on the frontal drainage type and anatomy of frontal recess of the distribution channel.　Methods　The CT images of 1355 cases of nasal sinus were anatomically observed and diagnosed of frontal sinusitis. All of them underwent thin-layer scanning and multi-planar reconstruction. The gasification frontal sinus were classified according to uncinate attachment site: attachment to the orbital wall, sieve plate and skull base were frontal sinus drainage type I, II and III. The anatomical characteristics and variation of the frontal recess air chamber were observed. The frontal recess gas room was classified according to the international frontal sinus anatomy classification ( IFAC ). Results A total of 1355 patients, 2582 sides of frontal sinus were gasified. There were 456 cases of frontal sinusitis of them. The incidence of inflammation in type II and III frontal sinus drainage channels was higher. Type I was different with type II and III with statistical significance (P<0.05). There was no significant difference between type II and III（P＞0.05）. The agger nasi cell (ANC) and supra bulla cell (SBC) were “permanent air chambers”. The incidence of inflammation was similar to the average incidence of frontal sinus inflammation. The rest of the types of frontal crypt air chamber had statistical significance for the incidence of frontal sinus inflammation（P<0.05）. Conclusion Both the variation of frontal sinus drainage channel and the gasification of frontal sinus recess gas room have important impact on the frontal sinus inflammation. High resolution CT scan and multi-planar reconstruction can clearly reflect the frontal sinus drainage around the channel variation and different type of gas room real anatomy.