MSCT斜轴位多平面重组图像在面神经管膝状窝及其周围骨折诊断中的价值

目的探讨MSCT扫描斜轴位MPR在面神经管膝状窝及其周围骨折中的诊断价值。方法收集经行颅中窝面神经减压手术证实的面神经管膝状窝或鼓室段近端骨折患者33例,回顾分析其术前CT图像,将术中所见与常规轴位、冠状位及斜轴位MPR图像所见对比。比较2种诊断模式(常规轴位及冠状位联合应用,常规轴位、冠状位及斜轴位MPR联合应用)对面神经管膝状窝及其周围骨折的诊断符合率。结果术前CT显示骨折线累及膝状窝或鼓室段近端22例(66.67%),其中常规轴位显示8例(24.24%),冠状位显示6例(18.18%),斜轴位显示20例(60.61%)。常规轴位或冠状位及斜轴位图像均能显示骨折线累及膝状窝或鼓室段近端10例,仅斜轴位显示12例,常规轴位、冠状位或斜轴位均不能显示11例。斜轴位MPR显示面神经管膝状窝或鼓室段近端局限性扩大26例(78.79%)。统计分析表明2种不同的诊断模式对膝状窝及其周围骨折诊断符合率有统计学差别。结论斜轴位MPR与常规轴位、冠状位图像联合观察可提高术前面神经管膝状窝及其周围骨折的诊断符合率。

Value of Oblique Axial MPR Imaging of MSCT in Diagnosing the Fracture of Geniculate Fossa of Facial Nerve Canal and Its Nearby

Objective To evaluate the diagnostic value of oblique axial multiplanar reformation(MPR)imaging in detecting the fracture of geniculate fossa of facial nerve canal and its nearby.Methods 33 cases of facial nerve canal or nearby fracture confirmed by surgery were collected.CT findings(including conventional axial,coronal and oblique axial MPR images)were retrospectively analysed in comparison with that of operation.The diagnostic corresponding rate of two diagnostic modes(the combination of routine axial and coronal imagings,the combination of routine axial,coronal and oblique axial imagings)were compared.Results The fractures of geniculate fossa or the proximate of tympanic segment were seen in 22 cases on pre-operation CT images,including 8 cases on routine axial images,6 cases on routine coronal images and 20 cases on oblique axial MPR images.Local enlargement of geniculate fossa or the proximate of tympanic segment were seen in 26 cases on oblique axial MPR images.There were significant differences between these two diagnostic modes.Conclusion Oblique axial MPR images in combined with routine axial and coronal images can improve the diagnostic corresponding rate of the fracture of geniculate fossa and its nearby.