翼腭窝及其通道的CT影像与断层标本对照研究及临床意义

目的观察CT影像和断层标本上对翼腭窝及其通道的解剖学特点，为翼腭窝病变的影像诊断及手术入路提供依据。方法选取我院2012年3月—2013年1月翼腭窝及其通道区域未见异常的40名成人检查者的CT影像，采用多平面重组（MPR）技术进行重建图像。选用成人尸体头颈部标本30例，分别制成连续横、矢、冠状断层（各10例）。分别在CT影像及断层标本上，观察并测量翼腭窝及其通道的长度和宽度等径线。结果CT影像和断层标本横断层面可清晰显示翼腭窝前、后壁和翼管、蝶腭孔、翼上颌裂等通道，矢状层面能较好显示圆孔和翼腭管及腭大、小管的连续性，冠状层面利于观察翼腭窝内侧、上壁和眶下裂、翼管及其与蝶窦的关系；在经蝶骨体横断层面上的翼腭窝形态较固定，前后径分别为（6．16±0．65）mm和（6．22±0．44）mm，内外侧径分别为（23．10±1．16）mm和（23．34±0．67）mm。翼腭窝及其通道呈对称性，CT影像和断层标本的径线除眶下裂前后径外差异均无统计学意义（P值均〉0．05）。结论不同方位的CT影像和断层标本能清楚显示翼腭窝及其通道的解剖学关系，对翼腭窝病变的影像诊断及手术入路具有重要临床意义。

Comparative study of pterygopalatine space and its paths on the CT image and sectional specimen

Objective To observe pterygopalatine space and its paths on the CT image and sectional specimens, provide the basis for imaging diagnosis and surgical approach for the diseases of pterygopalatine space. Methods The CT image of 40 adult volunteers with no abnormalities of the pterygopalatine space and its paths were selected, and reconstructed by the muhiplanar reformation （MPR） in our hospital from March 2012 to January 2013. Thirty heads and necks of adult corpses were selected and cut into transverse, sagittal and coronal sequence section respectively. Pterygopalatine space and its paths were observed and measured in the length and width on the CT imaging and sectional specimen. Results It was better to show the anterior, posterior wall of pterygopalatine space and its paths, including pterygoid canal, sphenopalatine foramen and pterygomaxillary fissure on transverse section of CT image and sectional specimens. To show succession of the foramen rotundum, pterygopalatine canal and greater palatine canal, less palatine canal on sagittal section. It was helpful to observe the medial, superior wall of pterygopalatine space, inferior orbital fissure, pterygoid canal and the relationship of it to the sphenoidal sinus. Its shapes of pterygopalatine space were immovable through the sphenoinal body on transverse section. They were （6.16 ＋ 0.65 ） mm and （ 6.22 ± 0.44） mm in posteroanterial diameter, （ 23.10 ± 1.16） mm and （ 23.34 ± 0.67 ） mm in medialateral diameter of the pterygopalatine space, respectively. Pterygopalatine space and its paths were symmetrical. There were no significant difference in the diameter except the posteroanterial diameter of inferior orbital fissure on the CT image and sectional specimens （ P 〉 0. 05 ）. Conclusions It can clearly show the anatomical relationship of pterygopalatine space and its paths on different orientations of the CT image and sectional specimens, it has an important clinical significance for imaging diagnosis and surgical approach of the diseases of pterygopalation space.