蝶筛外侧壁HRCT影像解剖学研究

目的：探讨蝶筛外侧壁与颈内动脉(ICA)和视神经(ON)的毗邻关系及其临床意义。资料与方法：回顾性分析80例(160侧)颅底高分辨率CT(HRCT)轴位图像。评价ICA和ON在蝶筛外侧壁上形成隆起的形态特征及视神经管(OC)与蝶筛外侧壁的毗邻关系。结果：ICA隆起型27侧(16．88％)，压迹型68侧(42．50％)，远离型65侧(40．62％)；ON隆起型46侧(28．75％)，压迹型95侧(59．38％)，远离型19侧(11.87％)；OC46侧(28．75％)全程与蝶窦外侧壁毗邻，40侧(25％)全程与后组筛窦毗邻，61侧(38.13％)与两者共邻。结论：颅底轴位HRCT扫描能够很好地评价蝶筛外侧壁毗邻的解剖关系，可以在术前为蝶筛区域手术提供精确的解剖信息，不仅能有效地提高手术的安全性，还有助于手术进路的选择及手术方案的确定。

HRCT Anatomy of the Lateral Wall of Sphenoid-ethmoidal Sinuses

Objective To discuss the relationship of the lateral wall of the sphenoid-ethmoidal sinuses with the internal carotid artery (ICA) and the optic nerve (ON).Materials and Methods Axial HRCT findings of 80 temporal bones (160 sides) were retrospectively analyzed. The morphological features of the protrusion on the lateral wall of sphenoid-ethmoidal sinuses produced by ICA and ON, and the neighboring relations between optic canal (OC) and the lateral wall of sphenoid-ethmoidal sinuses were evaluated.Results For the manifestation of ICA on the lateral wall of the sphenoid-ethmoidal sinuses, protruded type was seen in 27 sides (16.88%), depressed type in 68 sides (42.5%) and separated-away type in 65 sides (40.62%). For ON, protruded type was seen in 46 sides (28.75%), depressed type in 95 sides (59.38%) and separated-away type in 19 sides (11.87%). For OC, its whole course was neighbored with the lateral wall of sphenoid sinuses in 46 sides (28.75%), with the posterior ethmoidal sinuses in 40 sides (25%), and with both sinuses in 61 sides (38.13%). Conclusion Axial HRCT of the cranial base can well show the relationship between the lateral wall of sphenoid-ethmoidal sinuses and its neighboring structures, thus, providing clinicians with important anatomic information, which is very useful not only for the planning of the surgery, but also for the improvement of the operation safety.