螺旋CT仿真内镜技术在内镜下经鼻视神经减压术中的应用

The application of helical CT virtual endoscopy in nasal endoscopic optic nerve decompression

目的评价螺旋CT仿真内镜技术在内镜下经鼻视神经减压术中视神经管定位的应用价值。方法回顾性病例研究。收集2009年10月至2011年3月在温州医学院附属眼视光医院行内镜下经鼻视神经减压术的患者45例，男38例，女7例，平均年龄（32．8±15．1）岁。所有患者术前行螺旋CT扫描并通过CT仿真内镜技术重建蝶窦或筛窦外侧壁及定位视神经管，并与术中实际结果进行对比。结果除4例视神经管粉碎性骨折患者外．其他患者经CT仿真内镜均能很好显示蝶窦或筛窦外侧壁以及定位视神经管，并与术中结果基本一致。CT仿真内镜显示具有定位意义的蝶窦内骨嵴8例（19．51％），视神经一颈内动脉隐窝患者35例（85.37％），与术中结果一致。结论螺旋CT仿真内镜能立体的、直观的显示蝶窦或筛窦外侧壁以及视神经管定位，可以为术者提供立体、直观的影像学资料。

Objective To evaluate the significance of helical CT virtual endoscopy in nasal endoscopic optic nerve decompression for locating the optic nerve canal. Methods It was a retrospective case series study. 45 patients （38 males, 7 females） undergo the nasal endoscopic optic nerve decompression in the affiliated eye hospital of Wenzhou Medical College between October 2009 and March 2011 were collected. The average age of patients was 32.8＋15.1 （9-67 years）. Sinus cavity of all patients were reconstructed by helical CT virtual endoscopy and the data were compared with the results of operations. Results Sinus cavity and the locating mark of optic nerve reconstructed by helical CT virtual endoscopy accorded with the the results of operations in all patients, except 4 patients with optic canal comminuted fractures. Sphenoid sinus crest bone were found in 8 ptients （19.51%） and the opticoearotid recess were found in 35 patients （85.37%） which were wally reconstructed by helical CT virtual endoscopy, and were confirmated in operations. Conclusion Sinus cavity and the locating mark of optic nerve can be wally reconstructed by helical CT virtual endoscopy, which can provide a visual, clarity image for operator.