计算机辅助额窦引流通道三维搭积木重建

Computer-aided three-dimensional building block reconstruction of the frontal drainage system

目的探讨Mimics软件在额窦引流通道三维重建中的应用价值。方法对2007年5月至2008年3月收治的20例(37侧)需开放额隐窝的鼻窦炎患者,利用64层螺旋CT对鼻窦进行薄层扫描,导出CT影像的Dicom数据。利用Mimics10.0软件,对兴趣区图像进行分割、建模,搭建额窦引流通道的三维模型。所有患者术中均开放额隐窝。术后随访1年。结果所有CT数据均能很好地实现搭积木重建,比较直观地显示额窦引流通道及周围结构。37侧额隐窝、筛泡均可显示,3例(3侧)钩突缺如,7例(9侧)鼻丘气房缺如,15例(20侧)显示筛泡上隐窝。1年后复查CT,显示额隐窝周围气房残留少,额窦反应消退,额隐窝引流通畅。结论利用计算机软件可以实现搭积木重建额隐窝结构图,为鼻部疾病的影像诊断和鼻内镜手术提供了形态学参考。

Objective To investigate the value of Mimics software in the three dimentional reconstruction of frontal drainage system. Methods Dicom data on 20 frontal sinusitis patients who needed to open the frontal recess were obtained by the 64 thin-slice spiral CT scanning. The contour of organs was segmented from CT images and three dimentional model of the frontal drainage system was reconstructed by the Mimics 10.0 software. Frontal recess was opened in all patients. Results Three dimentional visible models of the frontal drainage system were reconstructed successfully. A 3-dimensional picture of this region could be displayed showing spatial positions and adjacent relationships of different anatomical structures. Three-dimentional visible models of the ethmoidal bulla and the frontal recess were successfully reconstructed in 37 sides. Uncinate was absent in 3 cases（3 sides） and agger nasi cells was absent in 7 cases（9 sides）. Suprabullar recess was present in 15 cases（20 sides）. The CT images taken one year later showed that there were little remained cells around the frontal recess, the frontal response disappeared and the frontal recess drainage was smooth. Conclusions Three-dimensional models of the frontal drainage system could be reconstructed by the Mimics software, which may provide morphological data for imaging diagnosis of nasal diseases and for nasal endoscopic surgeries