多层螺旋CT及多平面重组在颅底骨折诊断中的应用

Application of Multi-Slice Spiral CT Scanning together with Multiplanar Reformation in Diagnosing Skull Base Fractures

目的探讨多层螺旋CT及多平面重组在诊断颅底骨折中的价值。方法回顾性分析42例经多层螺旋CT检查确诊为颅底骨折患者的临床及影像学资料。结果 42例中,多块骨骨折35例,单一骨骨折7例。粉碎性骨折38例,线性骨折4例。前颅窝底骨折23例,其中额骨骨折21例,右侧筛板骨折11例,左侧筛板骨折12例,右侧蝶骨小翼骨折4例,左侧蝶骨小翼骨折5例。中颅窝底骨折38例,其中蝶骨体骨折28例,右侧蝶骨大翼骨折8例,左侧蝶骨大翼骨折16例。后颅窝底骨折24例,其中右侧颞骨鳞部骨折9例,左侧颞骨鳞部骨折9例,右侧颞骨乳突部骨折4例,左侧颞骨乳突部骨折4例,右侧颞骨鼓部骨折3例,左侧颞骨鼓部骨折3例,右侧颞骨岩部骨折6例,左侧颞骨岩部骨折7例,枕骨骨折5例。其中累及右侧视神经管11例,左侧视神经管15例,右侧眶上裂2例,左侧眶上裂3例,右侧圆孔2例,左侧圆孔7例,右侧卵圆孔2例,左侧卵圆孔1例,右侧翼管2例,左侧翼管4例,右侧岩骨段颈内动脉管6例,左侧岩骨段颈内动脉管6例,右侧破裂孔4例,左侧破裂孔6例,右侧颈静脉球壁1例,右侧面神经管1例,左侧面神经管3例,枕骨大孔4例。结论多层螺旋CT能够更清晰、准确、直观地显示颅底骨折的部位、范围,是目前确诊颅底骨折的有效检查方法。

Objective To discuss the application of multi-slice spiral computed tomography（MSCT） and multiplanar reformation in diagnosing skull base fractures.Methods A total of forty-two cases with MSCT-proved skull base fracture were enrolled in this study.The clinical data and imaging materials were retrospectively analyzed.Results Of the 42 patients included,multiple bone fracture was seen in 35 and single bone fracture in 7.The type and location of the fractures included comminuted fracture（n=38）,linear fracture（n=4）,anterior cranial base fracture（n=23）,middle cranial base fracture（n=38） and posterior cranial base fracture（n=24）.The specific locations of the fracture included right ethmoid labella（n=11）,left ethmoid labella（n=12）,right less wings of sphenoid bone（n=4）,left less wings of sphenoid bone（n=5）,sphenoid body（n=28）,right great wings of sphenoid（n=8）,left great wings of sphenoid（n =16）,right squamous part of temporal bone（n=9）,left squamous part of temporal bone（n=9）,right mastoid part of temporal bone（n=4）,left mastoid part of temporal bone（n=4）,right tympanic bone（n=3）,left tympanic bone（n =3）,right petrous part of temporal bone（n=6）,left petrous part of temporal bone（n=7）,occipital bone（n=5）,right optic nerve canal（n=11）,left optic nerve canal fracture（n=15）,right superior orbital fissure（n=2）,left superior orbital fissure（n=3）,right round orifice（n=2）,left round orifice（n=7）,right ovale foramen（n=2）,left ovale foramen（n=1）,right pterygoid canal（n=2）,left pterygoid canal（n=4）,right internal carotid canal（n=6）,left internal carotid canal（n=6）,right lacerated foramen（n=4）,left lacerated foramen（n=6）,right wall of jugular bulb（n =1）,right facial canal（n=1）,left facial canal（n=3）,and great occipital foramen（n=4）.Conclusion MSCT can accurately and clearly display the location and extent of the skull base fractures,and this technique is the best examination method in diagnosing skull base fractures.