多层螺旋CT在第一、二鳃弓综合征诊断中的应用

The application of multislice CT in the diagnosis of the first and second branchial arch syndrome

目的：研究多层螺旋CT（MSCT）及其重建技术在第一、二鳃弓综合征的诊断及鉴别诊断中的应用价值。方法：回顾性分析两年内经临床证实的26例患儿的MSCT资料,包括原始轴位、多平面重组（MPR）及容积重组（VR）图像。结果：MSCT发现的26例第一、二鳃弓综合征中,右侧13例,左侧13例。下颌骨均有不同程度的发育异常,以升支缩短为主,其中Ⅰ型3例,ⅡA型12例,ⅡB型7例,Ⅲ型4例。9例颧骨发育不良,3例上颌骨发育不全。大口畸形22例,耳廓畸形9例,21例有1~4个附耳和（或）皮赘,外耳道狭窄2例,外耳道闭锁7例,听小骨畸形7例。咀嚼肌及腺体发育不良,以咬肌及腮腺为代表,13例无咬肌组织,10例咬肌不同程度变小;11例无腮腺组织,10例不同程度腮腺发育不良。1例伴小下颌畸形,3例两侧侧脑室稍宽,余颅内结构未见明显异常。26例均无眼部异常及颅缝早闭征象。结论：MSCT及其重建技术不仅可以确诊本病,而且对鉴别诊断及外科手术有重要的临床意义。

Objective： To study the value of multislice CT（ MSCT） and reconstruction techniques in the diagnosis and differential diagnosis of the first and second branchial arch syndrome. Methods： 26 pediatric patients who underwent MSCT were retrospectively analyzed and were clinically confirmed within two years. The original axis,multiplanar reconstruction（ MPR） and volume reconstruction（ VR） images were performed in all the cases.Results： MSCT scans revealed 26 the first and second branchial arch syndrome： 13 right and 13 left. All of26 cases had different degrees of mandible dysplasia,which were characterized by shortened mandibularbranch,of which 3 type Ⅰ,12 type Ⅱ A,7 type Ⅱ B,4 type Ⅲ. 9 cases had zygomatic dysplasia. 3 cases had maxillary hypoplasia. 22 cases had transverse facial cleft. 9 cases had auricle deformity. 21 cases had 1-4 accessory ear and（ or） auricular tag. 2 cases had external auditory canal stenosis. 7 cases had external auditory canal atresia. 7 cases had otosteon deformity. Masticatory muscles and glands dysplasia represented by the masseter and parotid gland,in which 13 cases had no masseter,10 cases had masseter dysplasia; 11 cases had no parotid gland and 10 cases were with different degree of parotid gland dysplasia. 1 case was with small chin deformity. 3 cases were only with the lateral ventricle extended slightly. All of 26 cases had no abnormal eye and craniosynostosis signs. Conclusion：MSCT and reconstruction techniques can not only diagnose the disease,but also be useful for the differential diagnosis and have important clinical significances in surgery.