侧颅底CT三维重建的临床应用研究

Application of three demensional reconstruction of CT in lateral cranial base surgery

目的探讨ＣＴ三维重建在侧颅底外科的临床应用价值。方法对５例健康成人和１０例侧颅底病变患者（包括颈静脉球瘤３例，听神经瘤２例，颞骨骨折、颞骨骨纤维异常增殖症、颈静脉孔区软骨肉瘤、颈静脉孔区神经鞘瘤、颞骨嗜酸性肉芽肿各１例）在ＰｈｉｌｉｐｓＴｏｍｏｓｃａｎＳＲ７０００全身ＣＴ机上按骨窗条件以１．５ｍｍ层厚连续轴位扫描，扫描范围包括颞骨岩部上面或病变上缘到侧颅底下面骨性标志或病变最下缘。将扫描所获取的原始数据输入ＥａｓｙＶｉｅｗｉｎｇ三维图像工作站进行计算机图像三维重建处理。结果侧颅底ＣＴ三维重建图像能清楚显示正常颅底孔裂和重要的骨性标志、侧颅底病变的范围、颅内外受累情况以及与周围的解剖关系，对于颈静脉孔区病变三维ＣＴ具有鉴别诊断意义，还可模拟手术，帮助手术方案的设计。结论三维ＣＴ在侧颅底外科具有重要的临床应用价值，有利于手术方案的设计。

Objective To study the characteristics of 3D CT of the lateral cranial base and its application in lateral cranial base surgery. Methods Five normal adult subjects and 10 with lateral cranial base lesions were scanned with Philips Tomoscan SR 7000 CT scanner. The scanning ranges extended from the top to the bottom of the temporal bone, including whole lesions, with bone window algorithm and contiguous serial 1.5 mm thin cut scans in succession in axial plane. The 3D CT reconstruction was processed in the Easy Viewing CT / MRI workstation. Results The 3D CT reconstruction could clearly delineate the foraminan, fissures and important bony marks. The ranges of the lesions , the relationships between the lesions and the structures around them were demonstrated more clearly than 2D CT. It was of important significance in differential diagnosis for jugular foramen lesions. 3D CT could be used to imitate operation and design operative plan .Conclusion 3D CT was of important value in diagnosis of lateral cranial base tumors , and could be used to imitate operation and design operative plan.