翼腭间隙通道的CT三维重建及临床意义

CT Three-dimensional reconstruction and clinical significance of the pterygopalatine space

目的为翼腭间隙通道及其邻近结构病变的影像诊断和内镜手术提供解剖学资料。方法选取志愿者40名,在螺旋CT机上沿眦耳线(CML)连续扫描,将原始图像数据输入CT三维重建工作站,采用多平面重组技术(MPR),沿翼腭间隙各通道长轴和垂直于各通道长轴分别进行CT图像重建。观察翼腭间隙通道的位置、形态及毗邻结构,测量其径线。结果 MPR重建CT影像可清楚显示翼腭间隙通道的圆孔、翼管、蝶腭孔、眶下裂、翼上颌裂、翼腭管、腭大管、腭小管、腭鞘管和犁鞘管的位置、形态及其毗邻结构,左、右侧翼腭间隙通道呈对称性分布,各径线均无显著性差异(P>0.05)。圆孔、翼管、腭鞘管和犁鞘管位于蝶窦周围,可轻度或明显凸入蝶窦腔内。圆孔和翼管分别位于蝶窦腔的上、下方,长度(4.05±0.81)mm和(14.49±1.60)mm,冠状重建影像可较清晰显示其位置关系。结论翼腭间隙通道的CT三维重建对翼腭间隙通道及其邻近结构病变的影像诊断和内镜手术具有重要的临床意义。

Objective To provide anatomical data for imaging diagnosis and endoscopic operation of the diseases of pterygopalatine space communications and its adjacent structures. Methods 40 volunteers were selected and scanned in series by spiral CT from canthomeatal line （CML）. All original images were transferred to the CT three-dimensional reconstruction workstation, and the pterygopalatine space communications were reconstructed through its long axis and perpendicular axis to long axis by the multiplanar reformation （MPR） respectively. The position, communications were observed and measured. shape and adjacent structures of pterygopalatine space Results MPR reconstruction CT imaging could clearly display the position, shape and adjacent structures of pterygopalatine space communications, including the foramen rotundum, pterygoid canal, sphenopalatine foramen, inferior orbital fissure, pterygomaxillary fissure, pterygopalatine canal, greater palatine canal, lesser palatine canal, palatovaginal canal and vomerovaginal canal. Pterygopalatine space communications were symmetrical of left and right sides, there were no significant difference in the diameter （P〉0.05）.;Foramen rotundum, pterygoid canal, palatovaginal canal and vomerovaginal canal located around the sphenoid sinus, slightly or obviously protruding into the cavity of sphenoid sinus. Foramen rotundum and pterygoid canal located in the superior and inferior of the cavity of sphenoid sinus, with the length of 4.05±0.81 mm and 14.49±1.60 irma respectively. It was clearly to show the adjacent relationship of pterygopalatine space communications on coronal imaging. Conclusions It is important for imaging diagnosis and endoscopic operation of the diseases of pterygopalation space communications and its adiacent structures, under CT reconstruction images.