面神经管变异的多层螺旋CT曲面重建与解剖对照研究

目的：探讨面神经管解剖变异的曲面重建（CPR）与解剖对照及其可靠性。方法：20具（40侧颞骨）成人尸头标本行高分辨CT扫描及面神经管轴位、冠状位和矢状位曲面重建，观察重建图像上面神经管各段的走行及有无变异并测量缺裂的范围、膨大处的直径和长度；对40侧颞骨标本的面神经管进行解剖，观察面神经管有无变异，并测量缺裂的范围、膨大处的直径和长度。结果：①面神经管解剖变异34侧，发生率为85．0％，其中8侧并发2种变异，共计42处变异，其中走行异常23侧；缺裂14侧；分支变异2侧；局部膨大3侧。②3个位置的CPR图像均可准确显示并测量水平段、垂直段骨质缺裂和局部膨大；轴位与冠状位CPR重建图像能准确显示和测量膝状神经节处的骨质缺损。③能直观、准确显示有成角的走行变异，部分显示分支变异。结论：面神经管高分辨力CT图像的CPR能准确反映解剖变异与畸形，是研究面神经管影像解剖的良好及可靠方法，可部分代替解剖观察。

The study of comparing the anatomy with curved planar reformatted CT of the facial nerve canal

OBJECTIVE: To study the reliability of curved planar reformatted (CPR) CT of the facial nerve canal. METHOD: Tweny-two adult head cadavers with 40 sides of tempotal bone were examined by CT of high resolution and curved planar reformatted CT, then were anatomized. The length,diameter and two angles were measured both on the image of CPR and cadavers,as well as the course and aberrance of the facial nerve canal were investigated. RESULT: (1) The total number of the malformation sides were 34, the percentage was 85%. Among them, 23 sides were aberrant, 14 sides were dehiscent, 2 sides were bifurcate,3 sides were partially expanding. (2) The images of CPR could accurately reveal and measure the dehiscence of the horizontal, vertical segment and the expanse. The axial and coronary of CPR were superexcellent at disclosing the dehiscence of the first geniculation, especially the axial CPR. (3) The images of CPR could accurately and intuitionisticly reveal the aberrance with angle. CONCLUSION: The CPR of high resolution computed tomography was a superexcellent method to study the radioanatomy of the facial nerve canal,and can partially replace the anatomical measurement and modality observation of the facial nerte canal.