用于颧眶复合体骨折患者的改良CT突眼度测量方法

An improved method to measure the eyeball protrusion with spiral CT in orbit injured

目的:探索可用于眶外缘骨折移位患者的CT突眼度测量方法。方法:17例单侧颧眶复合体骨折患者,接受眶周螺旋CT扫描,重建眼眶至颞骨的三维骨组织模型,并在双侧眼球各自的最大径层面标定单个眼球的最前点(AP)和对应侧眶外缘的最前点(Ex)。在三维重建模型上标定双侧耳门上点(P、P')及健侧的眶下点(Or),分别记录AP、Ex在眶耳平面上至双侧耳门上点连线(PP')的投影距离AP'-PP'和Ex'-PP',并行双侧对比。结果:17例患者中,健侧眼球前点距PP'平均(86.26±3.40)mm(n=17),患侧平均距离(82.13±4.18)mm(n=16),双侧差值(4.00±2.63)mm(n=16)。健侧眶外缘点距PP'平均(73.38±4.07)mm(n=17),患侧平均(70.81±4.67)mm(n=16),双侧差值(2.54±1.71)mm(n=16)。结论:本改良CT突眼度测量法适用于因外伤或局部肿瘤等原因改变了正常眶外侧解剖结构的患者,可以有效的分别反映患者眼眶和眼球的实际空间位置变化。

Objective To find out an improved method to measure eyeball protrusion based on spiral CT for patients with orbital injuries. Methods 17 patients with unilateral orbital-zygomatic complex fractures received a periorbital CT scan. The digital 3D models were then reconstructed with the anterior eyeball point （AP） and the exterior orbit point （Ex） being tagged during reconstruction. Bilateral portions （P） and the inferior orbit point （Or） on the uninjured side were marked. Bilateral AP and Ex were projected onto Por Plane as AP′ and Ex′. The projected distance between AP and PP′（AP′- PP′） and the project distance between Ex and PP′ （Ex′-PP′） were documented. Results the average AP＇-PP＂ on the uninjured side was（86.26±3.40）mm （n=17）while that on the affected side was（82.13±4.18）mm （n=16）. The discrepancy was （4.00±2.63） mm （n=16）. The unaffected average Ex′-PP′was（73.38±4.07）mm （n=17）. and on the injured side, was （70.81±4.67）mm（n=16）, with a discrepancy of （2.54±1.71）mm（n=16）. Conclusions With this CT evaluation method, the movement of the injured eyeball within the orbit was able to be observer separately to permit appropriate treatment. This method may prove valuable in clinics will access to this technology treating similar injuries.