新区额隐窝区域CT影像学对鼻内镜外科的指导意义

目的通过观察额隐窝区域CT影像学特征,探讨其对额窦疾病的诊断及鼻内镜手术的意义。方法选择62例患者做冠状位鼻窦多排螺旋CT扫描,观察影像学上鼻丘气房、钩突上端附着点、额气房、眶上气房、额泡气房和额窦内间隔气房。结果鼻丘气房出现率67.7%,钩突前上部参与构成鼻丘气房的内壁、上壁、下壁和后壁,后上部向上可有单一附着点或2个附着点,钩突后上部的单一附着点主要位于眶纸板,也可附着于中鼻甲或颅底,钩突后上部的2个附着点主要附着于眶纸板和颅底,额泡气房Ⅰ、Ⅱ型(40.3%)最多见,Ⅲ和Ⅳ型(12.9%)少见,额窦间隔气房的出现率5.6%。结论多排螺旋CT能良好地显示额隐窝解剖结构,为额窦病变的临床诊断和术前手术计划的制定提供有价值的解剖信息。

Computed tomographic analysis of frontal recess region to endoscopic surgery

Objective To observe the imaging features of frontal recess region by multi detector row CT imaging,and explore its helpful information in diagnosing frontal sinus disease and creating nasal endoscopic frontal sinussurgery.Methods Sixty-two patients were undergone coronal nasal sinus multi detector row spiral CT scan,and the structures of agger nasi cell,uncinate process’ superior attachment,frontal cell,superorbital cell,frontal bullar cell and interfrontal septal cell were recognized.Results The prevalence of agger nasi cell was 67.7%.The anterior and superior part of uncinate process participated in the constitution of the inner,superior,inferior and posterior walls of agger nasi cell.The posterior and superior part of uncinate process had one or two attachments.The single attachment of uncinate process was identified mainly on the lamina papyracea,as well as on middle turbinate or skull base.The two attachment of uncinate process was identified on the lamina papyracea and skull base.Of the frontal cells,the prevalence of typeⅠandⅡwas 40.3%,and type Ⅲ and Ⅳwas 12.9%.The prevalence of interfrontal septal cell was 5.6%.Conclusion Multi detector row spiral CT can well display the anatomical structures of frontal recess,which is helpful for diagnosing frontal sinus disease and creating operation plans.