基于容积CT的成人钩突上段影像解剖学研究

Imaging anatomical study on the upper part of the uncinate process in adults based on volume CT

目的通过对容积CT采集的钩突上段及其邻近结构影像数据进行分析，探讨钩突上段的影像解剖及临床意义。方法选择100例（200侧）受检者，采用64层螺旋CT高分辨力（HRCT）扫描，多平面重组（MPR）后处理技术获得连续的标准化图像进行影像学观察。结果钩突上段不同附着位置发生率由多到少依次为：眶内壁＋中鼻甲32．5％；眶内壁＋颅底21．5％；眶内壁＋中鼻甲＋颅底21．5％；眶内壁18．5％；中鼻甲2．O％；颅底2．0％；颅底＋中鼻甲2．0％。200侧中，钩突上段与眶内壁可有O～3个附着点，其中与眶内壁有1个附着点的发生率最高，为44．5％。200侧中，171侧（85．5％）额窦引流到中鼻道，29侧（14．5％）额窦引流到筛漏斗。钩突上段与眶内壁的附着点参与构成鼻丘气房（aggernasicell，AN），200侧中，188侧（94．0％）存在AN，其中110侧（58．5％）额窦引流至AN内侧；55侧（27．1％）额窦引流至AN后方；27侧（14．4％）额窦引流至AN后内方。结论HRCT及MPR技术能够清晰的显示钩突上段及其变异的个体化影像解剖学特征，为临床诊疗决策提供有价值的信息。

Objective To investigate image characteristics and clinical significance in the upper part of uncinate process in adults by analyzing the image data detected by volume CT in the region and its neighboring anatomical structure. Methods 100 subjects （ 200 sides） underwent orbital CT scan with 64-slice spiral high resolution computerized tomography （ HRCT）, then the continuous coronal standardized images were obtained by MPR. Results The incidences of abnormality in different attachment positions of upper part of the uncinate process were in turn （from many to little） ：lamina papyracea ＋ middle turbinate 32.5% , lamina papyracea ＋ skull base 21.5% ,lamina papyracea ＋ middle turbinate ＋ skull base 21.5% ,lamina papyracea 18.5% ,middle turbinate 2.0% ,skull base 21.5% ,skull base ＋ middle turbinate 2.0%. Among the 200 sides,there were 0 - 3 attachment points in upper part of the uncinate process and lamina papyracea in which the incidence （44.5%） was the most in one attachment point in upper part of the uncinate process with lamina papyracea. Among the 200 sides, there were 171 sides （ 85.5% ） with frontal sinus draining into middle nasal passages, and 29 sides （ 14.5% ） were drained into sieve funnel. The attachment positions participated in constituting agger nasi cell （ AN ）. Among 200 sides, 188 sides had AN （94.0%） in which 110 sides （58.5%） were drained from frontal sinus to inner side of AN ,55 sides （27.1%） were drained to rear of AN,and 27sides （ 14.4% ） were drained from frontal sinus to rear inner position of AN. Conclusion HRCT and MPR technique can clearly display the anatomical characteristics and variable individualized image anatomical features in upper part of uncinate process,which can provide valuable information for clinical diagnosis and treatment decisions.