筛窦顶壁影像学分析

Imaging analysis of the ethmoid roof

目的:探讨筛窦顶壁高度及形态影像解剖学特征。方法:回顾性分析160例冠状位鼻窦CT,观察左 右侧筛窦顶壁形态及高度对称性、筛窦顶壁与筛板连接方式,测量左右侧筛窦顶壁高度差及筛窦顶壁与筛板间高 度差。结果:左右侧筛窦顶高度(差>1mm)不对称者25例(15.63%),其中右侧筛窦顶较左侧低13例 (52.00%),左右侧筛窦顶高度差平均为2.35mm。左右侧筛窦顶形态62例(38.75%)不对称,一侧鸟翼状另一 侧扁平状。筛窦顶与筛板水平式连接116侧(36.25%),高台式连接204侧(63.75%)。高台型筛窦顶与筛板高 度差平均为2.80mm。结论:筛顶在高度及形态上存在左右侧不对称性,且以形态的不对称性为常见。筛窦顶壁 与筛板的连接方式以高台式多见。鼻内镜手术前及手术中仔细阅读患者鼻窦CT片具有重要意义。

Objective:To discuss the image anatomy characters in the height and contour of the ethmoid roof.Method:Retrospective review of direct coronal sinus computed tomography (CT) scans in 160 patients. The height and contour of the fovea ethmoidalis, and the connection modes between ethmoidal roof and cribriform plate were examined. When an asymmetry in the height of the fovea ethmoidalis existed, this difference was quantified, and the difference between ethmoidal roof and cribriform plate was quantified in high type, too.Result:In 25 scans (15.63%) , there was an asymmetry between the height of the fovea ethmoidalis on the right and left sides. Of these 25, 13(52.00%) were lower on the right side. The difference between left and right was 2.35 mm.Sixty-two patients (38.75%) demonstrated a contour asymmetry with 'flattening' of the ethmoid roof on one side. Horizontal type was 116 sides(36.25%), and high type was 204 sides(63.75%) in the connection modes between ethmoidal roof and cribriform plate. The difference was 2.80 mm in the high type.Conclusion:There were asymmetries in the height and contour of the right and left fovea ethmoidalis. The asymmetry was most often the result of a difference in contour with flattening of the fovea on one side. The high type was the most connection modes between ethmoidal roof and cribriform plate.This underscores the importance of careful preoperative and intraoperative review of paranasal sinus CT scans in patients undergoing endoscopoic sinus surgery.