扩大经蝶窦入路影像解剖

Imaging Anatomy of the Extended Transsphenoidal Approach

【目的】为扩大经蝶窦入路手术提供CT影像学解剖资料。【方法】对20具头颅标本行CT冠状位矢状位及轴位扫描,进行与扩大经蝶窦入路相关的颅底结构的观测。【结果】CT多方位扫描观测见筛顶和筛板呈高台和平移两种位置关系,后组筛窦、蝶窦与视神经管关系分为蝶窦优势型、蝶筛均势型及筛窦优势型,以蝶窦优势型占多数(60%)。蝶嵴至双侧视神经管眶口垂直距离相比较无显著性差异(P>0.05)。【结论】①后组筛窦,蝶窦和视神经的毗邻关系,蝶窦气化类型及蝶窦分隔应作为扩大经蝶窦入路术前常规的影像学观测内容。②蝶嵴位于双侧视神经管眶口的中点,为术中可靠的中线标志。

[Objective]To provide imaging anatomy basis for the clinical application of extended transsphenoidal approach. [Methods]Twenty adult cadaver heads specimens fixed in formalin were studied through thin- ner CT scanning with coronal, sagittal and axial position, to provide the imaging anatomy basis related to the extended transsphenoidal approach. [Results]The multi-CT scanning could show the migration of the ethmoid roof and eribrum, the degree of pneumatization of the sphenoid sinus, the relationship between the posterior ethmoid sinus, sphenoid sinus and optic canal, which were divided into sphenoid sinus-dominant type, posterior ethmoid sinus-dominant type and equivalent type. The distance between the sphenoidal crest and the optic canals were equal. So the sphenoidal crest was the key midline landmark in the approach. [Conclusion] The multi-CT scanning can show the three-dimensional image of the skull base, which is significant to the clinical application of the extended transsphenoidal approach.