正常鼻骨细微解剖结构的MSCT影像学形态及法医学鉴定

The Subtle Anatomical Structures of Normal Nasal Bone in MSCT Image and Forensic Identification

目的通过对正常鼻骨多层螺旋CT(multi-slice spiral CT,MSCT)扫描及三维图像特征的观察,总结鼻骨细微解剖结构。方法对120例鼻骨无外伤史、无疾病史的志愿者行鼻区MSCT横断面扫描,重建层厚0.6mm、层距0.5mm的骨窗图像并导入Syngo Imaging XS软件中,进行三维图像重组。观察并分析鼻骨细微解剖结构的形态特征。结果正常鼻骨的细微解剖结构由四缝、两孔及一缘组成。其中四缝包括左、右鼻颌缝,鼻额缝以及鼻间缝,两孔为左、右鼻骨孔,一缘是鼻骨下缘。在某些个体,鼻间缝间会出现游离的缝间骨。鼻骨孔多为小孔状,但也有少数个体为线条状。鼻骨下缘可分为平直型、波浪型、倒尖峰型、月牙铲型以及其他类型。结论鼻骨解剖形态多样化且个体差异性较大,采用MSCT及三维图像重组技术,结合其外伤史有利于正确分辨鼻骨正常解剖结构和骨折。

Objective To summarize the subtle anatomical structures of the normal nasal bone in multislice spiral CT （MSCT） image through the observation of the threedimensional images. Methods One hundred and twenty volunteers who had no nasal trauma and disease history were collected. The nasal was scanned using MSCT. Raw data was reconstructed into bone window images （slice thickness 0.6 mm, slice interval 0.5 mm）, and then the images were imported into Syngo Imaging XS software to reconstruct threedimensional images and to summarize the nasal bone ’s subtle anatomical structures. Results The subtle anatomy of normal nasal bone generally included four seams, two holes and one edge. The four seams were left and right nasalmaxillary suture, nasalfrontal seam, and internasal suture. The two holes were left and right nasal aperture. The edge of the nasal was the lower edge of the nasal bone. In addition, there was suture bone in internasal suture in some normal nose. The nasal aperture mostly was holelike, but some nasal apertures were line shape. The nasal edge can be divided into flat type, waveshaped type, inverted spike type, hookshaped type and others. Conclusion The anatomy diversity and individual differences in nasal bone are large. MSCT and threedimensional image reconstruction techniques, combined with the history of trauma could distinguish between the normal anatomy and fractures.