健康人额筛气房的影像学研究

Spiral computed tomography analysis of fronto-ethmoidal cells in normal subjects

目的通过分析健康人额窦和额隐窝区域的 CT 影像学特征,了解额筛气房在国人中的出现率,进一步认识额窦和额隐窝区域重要解剖标志的临床意义。方法选择202人(404侧)无额窦疾病症状且额隐窝区域无病变表现的研究对象,对头部行16排螺旋 CT 扫描,然后在图像工作站上进行冠状位、矢状位和水平位图像重建。观察鼻丘气房、额气房、筛泡上气房、眶上筛房、额泡气房和额窦内间隔气房等额筛气房的出现比率,同时分析钩突后上端附着点的位置分布特征和终末隐窝的出现率。结果①额窦和额隐窝区域的多个气房需要依靠三维 CT 明确分类。②159侧(39.4%)出现额气房,其中Ⅰ型98侧(24.3%);Ⅱ型28侧(6.9%);Ⅲ型33侧(8.2%),未见Ⅳ型额气房。148侧出现筛泡上气房(36.6%);22侧出现眶上筛房(5.4%);36侧出现额泡气房(8.9%);25人出现额窦间隔气房(12.4%)。③380侧出现鼻丘气房(94.1%)。钩突后上端可有1个或2个附着点,244侧钩突后上端有单一附着点(60.4%),其中214侧(53.0%)附着于眶纸板;21侧(5.2%)附着于中鼻甲;9侧(2.2%)附着于颅底。160侧钩突后上端有两个附着点(39.6%),其中,111侧(27.5%)附着于眶纸板和颅底;35侧(8.7%)附着于眶纸板和中鼻甲;14侧(3.5%)附着于颅底和中鼻甲。360侧(89.1%)钩突后上端在眶纸板上有附着点,附着点与眶纸板接合部的下方形成终末隐窝。结论 16排螺旋 CT 结合三维图像重建技术可准确辨认额窦和额隐窝区域中额筛气房的解剖特征。

Objective The purpose of this study was to determine the prevalence of frontoethmoidal cells in normal Chinese subjects. Methods Two hundred and two Chinese subjects without symptoms of frontal sinus disease were undergone spiral computed tomography （CT）. The multiplanar reconstruction images were evaluated using a standard triplanar reconstruction protocol on a computer workstation. Results There were 121 males and 81 females. The mean age was （39.4 ±13. 5 ） years. Of all the frontal cells identified in 159 sides （39. 4% ） of frontal recesses, the prevalence of type Ⅰ ,type Ⅱ, type Ⅲ and type IV cells were 24. 3% （98 sides） ,6. 9% （28 sides） ,8. 2% （33 sides） and 0% （0 side） respectively. Suprabullar cell, supraorbital ethmoid cells, and frontal bullar cell were identified in 148 sides （36. 6% ）, 22 sides （5.4%）, and 36 sides （8.9%） respectively. While the interfrontal septal cells was found in 25 patients （12. 4% ）. The prevalence of agger nasi cell was 94. 1% （380 sides）. Two hundred and forty-four uncinate processes （60.4%） had one superior attachment for each uncinate process; the other 160 uncinate processes （39.6%） had two superior attachments for each uncinate process. The single superior attachment of the uncinate process into the surrounding structures was identified to have the following distribution： 53.0% （n =214） to the lamina papyracea, 5.2% （n =21 ） to the middle turbinate, 2. 2% （n =9） to the skull base. Most of the uncinate process＇ two superior attachments were either into the lamina papyracea and the skull base （27.5%, n = 111 ） or into the lamina papyracea and the middle turbinate （8.7%, n=35）. The other 14 uncinate processes （3.5%） superiorly attached to the skull base and the middle turbinate. The prevalence of recessus terminalis was 89. 1% （ n = 360）. Conclusion The result demonstrated the normal frontal recess pneumatization patterns in normal Chinese.