螺旋CT三维重建在鼻科的临床应用

Clinical application of three - dimensional reconstruction imaging of the nose and parasinuses by means of he- lical CT

目的 探讨螺旋CT三维重建图像在鼻腔、鼻窦中的应用价值。方法 上颌窦骨折38例,眶骨、筛窦骨折6例,下颌骨骨折4例,鼻骨骨折2例,额窦骨折2例;慢性鼻窦炎鼻息肉30例;鼻腔鼻窦肿瘤10例。所有骨折病例均用表面遮盖显示法重建出鼻腔窦骨壁表面情况,其余病例均用此法行空气表面投影法处理,重建出气道空腔表面情况,同时行仿真内窥镜成像和多平面重建。三维重建图像分别与原始冠状或轴位图、纤维内窥镜所见及手术所见对照。结果 (1)38例上颌窦骨折情况骨表面重建图与原始冠状或轴位图显示一致,与手术所见相符。(2)慢性鼻窦炎鼻息肉30例和鼻腔鼻窦肿瘤10例,空气表面投影法重建图像能清楚地显示含气腔和气道狭窄和堵塞情况,类似空气造影,所显示的病变范围大小与手术所见一致。(3)仿真内窥镜成像分别从前从后(足)端入路观察,可清楚地显示鼻腔内各结构及病变,与纤维内窥镜和手术所见描述基本一致。(4)多平面重建图像清晰,分辨率高,比冠状或轴位原始图,对窦口鼻道复合体等正常解剖结构,肿瘤和鼻息肉的位置、形态、及周围组织关系显示更清楚。结论螺旋CT(?)维重建图像显示鼻腔鼻窦病变准确,可多方位多角度观察病变,立体感强,有助于临床医生治疗。

To evaluate the ehnical application of three-dimensional reconsfruction imaging of the nose and parasinuses by means of helical CT. Methods Three - dimensional imaging ol the nose and parasmnses of 38cases with maxillofaeial fracture and 30 eases with chronic parasinusitis and 10 cases with tumours of the nose and parasmnses by spiral sunning were compared with 2D imaging and surgery. Results (1) Shaded Surface Display (SSD) could show the bone fracture clearly in all 38 cases with maxillofacial fracture, and could show the airway of 30 cases with chronic parasinusitis and 10 eases with tumors of the nose and parasinuses. (2) CT virtual endoscopy could display the anatomical structures in nasal cavity, septal deviation, nasal meatus narrowing and obstruction and masses, by means of 'half perspective' and 'clip' CT virtual endoscopy could demonstrate data of the bone and soft tissues either. (3) Mnltiplanar imaging could display anatomical structures and lesions from multiple views. Conclusion Three -dimensional imaging could demonstrate more data in displaying anatomical structure and lesions of the nose and parasinuses. It is helplrul for clinical doctors to treat and operate the nose and parasmnses diseases.