额隐窝区域结构立体影像研究

Computed tomographic images analysis of frontal recess anatomy based on three-dimension reconstruction

目的:对测试对象鼻窦区域行螺旋CT扫描后,将额隐窝区域内重要的含气结构行三维重建,对其中重要的解剖结构进行观察并测量相关参数。方法:选择30例因病接受鼻窦CT检查的患者为研究对象,对其头部行多排螺旋CT扫描(螺距1mm,扫描层厚2mm,层距-1mm),通过工作站对数据进行三维图像重建形成3D模型。对该模型上各种气房的结构、形态、相对空间排列以及其相应的引流途径进行观察及分析,对额窦和鼻丘气房的几何尺寸以及两者之间的空间距离进行相对精确地测量,并进行归纳、分析。结果:在重建后的额隐窝立体模型上可清晰地辨识出鼻丘气房、额气房等重要气房结构以其相互间的空间排列关系,并对其自然形态以及额窦引流模式有了直观的印象。鼻丘气房的高度为(9.45±3.60)mm,前后径为(8.08±3.37)mm,额窦的上下径和左右径分别为(26.98±6.82)mm、(26.86±9.45)mm,额窦底与鼻丘气房顶部之间的距离为(7.80±3.36)mm。结论:借助三维CT重建技术获得了额隐窝区域气房3D结构模型;该模型对认识和界定额隐窝区域各种气房结构有重要的指导意义,同时获得的相关参数可为额窦手术提供可靠的依据。

Objective：To observe the CT three-dimensional imaging features of the frontal recess region with advanced three-dimensional reconstruction, and develop the real image of the important anatomical structures around the region to conduct surgery. Method： Thirty patients were undergone spiral CT by 16 line high speed spiral CT, and multiplanar reconstruction images using standard three-dimensional reconstruction protocol on a computer workstation. The structure of the frontal recess, the agger nasi cell and adhere style of the uncinate process were observed. The parameter of the important anatomic structure of frontal recess was measured precisely. Result： After the reconstruction, we get the three-dimensional model very close to the true state of the nasal cavity-sinuses cell, in which parts of the frontal recess can clearly identify the agger nasi cell, frontal cell and other important struc- tures. In these patients, the height, width and depth of the agger nasi and frontal sinus were （9.45 ± 3.60）mm, （8.08±3.37）mm,（26.98±6.82）mm and （26.86±9.45）mm, respectively. Conclusion：This study tried to devel- op the standardized techniques and measurements from three-dimensional reconstructed images of the frontal sinus and to ascertain the usefulness of the frontal sinus in identification of patients. The project results in better preop- erative patient counselling and in predicting postoperative improvement in clinical status.