翼管的高分辨率CT(HRCT)研究

High-resolution CT findings of the pterygoid canal

目的：探讨翼管高分辨率ＣＴ（ＨＲＣＴ）正常及病理的表现。方法：回顾性分析１００例正常成年人翼管和７２例病变累及翼管的病例。结果：正常成年人右侧翼管长度１４．００ｍｍ（１７．０１～１１．００ｍｍ），左侧翼管长度 １４．００ｍｍ（１８． ０５～１１． ０３ｍｍ），男女两者无明显差异（ Ｐ＞０． ０５）；翼管前口宽度 ２．００ｍｍ（０．８０～４．００ｍｍ），后口宽度１．４０ｍｍ（０．５０～２．８０ｍｍ）；８５％翼管向前内走向，两侧翼管前部距离２５ｍｍ（１７～３１ｍｍ），后部距离２７ｍｍ（１９～３５ｍｍ）；翼管与蝶窦下壁前后的距离分别为２．４ｍｍ和３．０ｍｍ，以上三组数值均有显著差异（ Ｐ＜ ０． ０５），但男女之间无明显差异（ Ｐ＞０． ０５）。正常成人翼管与鼻窦关系：位于有完整分隔的蝶窦下５５％，蝶窦内３１％，不对称分隔或无分隔下８％，上壁缺如与蝶窦交通６％。病变累及翼管病理改变分三种类型：扩大１０例（１３．９％）；狭窄１７例（２３，６％）。消失４５例（９９．５％）。结论：ＨＲＣＴ能很好显示翼管骨性结构，准确认识翼管正常表现及与邻近结构关系，可以发现翼管早期病变并指导临床治疗。

Objective: To evaluate the morphological feature of the pterygoid canal in normal subjects and series diseases, the clinical data of pterygoid canal were studied retrospectively. Method: The pterygoid canal was observed by high--resolution CT (HRCT) in100 normal subjects(50 males and 50 females, age from 20 to 71 years old) and 72 patients whose pterygoid canals were affected by series diseases(nasal pharyngeal carcinoma 15, young angiofibroma 9, sphenoiditis 8, maxillitis 7, sphenoid sinus fibroelastosis 7,oral base cancer 4,nasal cavity cancer 3,ethnoid sinus cancer 3,Langerhan's histocytosis X 3, meningoma 2, orbital fibroneuroma 2, sphenoid sinus cancer 2, skull base cartilage osteosarcomatosis 2, cranial middle fossa notochordoma 1, nasal cavity rhabdomyosarcoma 1,nasal cavity mucoid adenocarcinoma 1, not in detail 2). Results: In normal subjects group: (1)The length was 14. 00 mm on both right and left pterygoid canal, and it was no different in sex (P>0. 05) ; (2) The width of anterior and post mouth of pterygoid canal were 2.0mm (0. 80-4. 00mm) and 1. 4mm(0. 5-2. 80mm) respectively, and was showed slightly narrower in anterior segment (25mm) than that in posterior segment (27mm). The distance between the sterygoid canal and inferior wall of sphenoid sinus was 2. 40mm (anteriorly) and 3. 00mm (posteriorly) (P<O. 05). These parameters were no significant difference in sexes (P>0. 05) ; (3) The pterygoid canal was beneath the sphenoid sinus in 55%, intra-sphenoid sinus in 31 %. In diseases group, the pathologic findings of pterygoid canal were enlargement in 13. 9 %,narrowing in 23. 6% and disappearance in 59. 5% respectively. Conclusion: The HRCT can define the structure of pterygoid canal very well, and realize accurately the normal appearance and the relation with adjacent structure, which would help for diagnosis and treatment of these diseases involved pterygoid canal.