上颌窦骨分隔及骨瘤患者锥形束CT影像学分析

Cone beam computed tomography imaging analysis of maxillary sinus septa and exostoses in 400 patients

目的:通过头颅锥形束CT检查,分析上颌窦骨分隔/骨瘤的解剖情况,为上颌窦相关手术提供解剖学指导。方法:收集400例拍摄头颅锥形束CT的患者,通过三维重建,观察上颌窦骨分隔/骨瘤的发生、形态、位置,使用专用测量软件测量骨分隔的高度及其与腭中缝的夹角,采用SPSS软件进行统计学分析。结果:以检查者人数为对象,上颌窦骨分隔发生率为32.25%,骨瘤为4.50%;以上颌窦数为对象,骨分隔发生率为22.75%,骨瘤为2.38%;52例(13.00%)出现多个骨分隔/骨瘤,36例(9.00%)双侧上颌窦同时出现骨分隔/骨瘤,不同缺牙分型上颌窦骨分隔/骨瘤的发生率差异无显著性;骨分隔形状中以锯齿状为主(39.4%);骨分隔/骨瘤主要发生在上颌窦中部(分别为51.52%、71.43%),上颌窦骨分隔的平均高度为(5.88±3.08)mm,与腭中缝的平均夹角为(66.36±16.17)°。结论:应用锥形束CT能较准确地观察上颌窦骨分隔/骨瘤的情况。

Objective To analyze the anatomical features of maxillary sinus septum and exostosis by cone beam computed tomography （CBCT） examination, and to offer anatomical instructions for maxillary surgery. Methods A total of 400 patients receiving CBCT scans were observed and analyzed. The occurrence, morphology and location were assessed by three-dimensional reconstruction. The height of septa was measured by the proprietary software. Also, angles between the direction of septum and median palatine suture were measured on axial images. Results 129 septa （32.25%） and 18 exostoses （4.50%） of the subjects were detected, corresponding to 22.75% and 2.38% of all maxillary sinuses and 13% of the subjects （n = 52） had multiple sinus septa, while 9.00% had bilateral sinus septa （n = 36）. The prevalence of septa or exostoses was not significantly with regard to the absence of teeth, Septa was observed mostly zigzagged and demonstrated a greater prevalence （51.52%） in the middle region, as well as exostoses （71.43%）. The mean septal height was （5.88＋3.08） mm, and the mean septum angle was （66.36±16.17）°. Conclusion Maxillary sinus septa and exostoses could be well observed by cone-beam CT.