翼管、圆孔和蝶腭孔的CT三维重建解剖学

Three-dimensional CT reconstruction anatomy of vidian canal, foramen rotundum and the sphenopalatine foramen

目的使用三维高分辨率CT(HRCT)重建的方法,观察经鼻内镜至翼腭窝(PPF)的手术入路中的重要解剖结构,探讨翼管(VC)、圆孔(FR)和蝶腭孔(SPF)这些重要解剖标志的三维立体空间关系。方法回顾性分析17例患者及1例尸体标本的HRCT扫描数据。在CT三维重建的影像中,观察SPF、VC和FR的形态以及SPF和VC之间的三维立体空间关系。结果三维测量SPF,VC,和FR的平均直径分别为(6.26±1.59)mm,(2.35±0.77)mm和(2.75±0.77)mm。VC和SPF后下缘之间的平均距离为(4.03±1.15)mm。三维立体CT重建影像中VC和FR之间的平均垂直和水平距离分别为(4.94±1.35)mm和(9.22±3.07)mm。VC的全部或部分边缘92%(33/36)位于SPF的下缘以上,97%(35/36)位于SPF内缘外侧。结论深入理解SPF、VC和FR之间的三维空间立体关系,有助于安全实行内镜下经鼻至翼腭窝的手术。

Objective To investigate the three-dimensional spatial relationships of the sphenopalatine foramen （ SPF） , vidian canal （ VC ） , and foramen rotundum （ FR ） with regard to an endoscopic endonasal approach to the pterygopalatine fossa（PPF）using three-dimensional reconstruction of high resolution computed tomography （HRCT） scans. Methods The HRCT scans of 17 patients and a cadaver specimen were retrospectively evaluated .The morphology of the SPF, VC, and FR as well as the spatial relationship between the SPF and VC were measured on the image of three -dimensional CT reconstruction.Results The mean diameters of the SPF, VC, and FR were（6.26 ±1.59）mm,（2.35 ± 0.77）mm and（2.75 ±0.77）mm, respectively.The mean distance between the VC and posteroinferior margin of SPF was （4.03 ±1.15） mm.The mean vertical and horizontal distances on the image of three-dimensional CT reconstruction were between the VC and FR were（4.94 ±1.35）mm and（9.22 ±3.07）mm, respectively.The whole or partial margin of the VC was above the inferior margin of the SPF in 92%（33/36） of the VC and lateral to the posterior margin of the SPF in 97%（35/36） of the VC.Conclusion The endoscopic endonasal approach to the PPF is performed with greater safety through comprehension of the spatial relationships between the SPF , VC, and FR.