颌面外科及正畸中三维CT的临床应用

The Application of Helical CT 3D Imaging in Maxillofacial and Dental Surgery

目的 探讨三维CT在颌面外科和正畸中的应用价值。资料与方法 颌面部骨折 5 5例 ,颌面部肿瘤 14例 ,颌骨及牙发育畸形 14例。所有病例均经螺旋CT扫描后进行骨的表面重建 ,肿瘤患者还行肿瘤区的多平面重建 ,颌骨畸形牙咬合错位者利用牙科软件行牙体的表面重建和牙根的多平面重建。重建图像分别与原始轴位图、手术所见对照 ,并与正畸模型进行对照。结果 (1) 5 5例颌面部骨折和 14例颌面部肿瘤三维重建图像显示的骨折、肿瘤部位与原始轴位图显示一致 ,与手术所见相符 ,而且立体感更强。 (2 ) 14例颌骨及牙发育畸形三维重建图像清楚显示颌骨畸形、牙咬合错位牙根方向的情况。根据三维图像制订、实施手术方案和矫形正畸计划 ,获得良好的效果。结论 三维CT可准确地显示颌骨的病变 ,可多方位、多角度观察病变 ,立体感强 ,有助于颌面外科疾病的治疗、手术计划的制订和实施 ,牙科软件行牙的表面重建及牙根的多平面重建 ,能清楚地显示各个牙根的走向 ,为牙的矫形。

Objective To evaluate helical CT 3D imaging in clinical maxillofacial and dental surgery.Materials and Methods With a helical CT scanner, 3D imaging was conducted in 55 cases with maxillofacial fractures, 14 cases with maxillofacial tumor or tumor-like lesions, and 14 cases with malformation of mandible bone and teeth. The images were compared with original axial images and surgical findings.Results (1) 3D imaging could well demonstrate the abnormalities in 55 cases with maxillofacial fractures and in 14 cases with maxillofacial tumor or tumor-like lesions. (2) 3D imaging could clearly display the mandible anatomy and the dental structure. Conclusion 3D imaging can precisely reveal bony structure and lesions of maxillofacial bone and teeth, which is very helpful for the physician in managing the maxillofacial and dental diseases.