基于CT图像的眶内侧壁结构差异与眼眶爆裂性骨折发生形态的相关性研究

The role of quantitative measurement of orbital medial wall in the morphology of blow-out fracture based on CT imaging

目的:基于CT图像眶内侧壁结构定量测量探讨眼眶内侧壁解剖特点与眼眶爆裂性骨折发生形态的相关性。方法 :收集因眼部外伤行眼眶CT扫描的患者,无眼眶骨折患者100例,单纯眼眶骨折患者76例(眶内侧壁骨折50例,眶下壁骨折26例)。眶内侧壁定量测量参数包括筛骨纸板前高、后高、前后径、面积及筛窦气房分隔数、单位筛窦气房分隔所支撑筛骨纸板面积。比较各组间眼眶内侧壁各定量测量参数的差异。结果:无骨折患者左右两侧眼眶内侧壁各定量测量参数无统计学差异(P>0.05)。眼眶内侧壁骨折组筛窦气房分隔数少于眼眶下壁骨折组(P=0.013),单位分隔所支撑的筛骨纸板面积大于眼眶下壁骨折组(P=0.011),而筛骨纸板前高、后高、前后径、面积无组间差异(P>0.05)。结论:左右两侧眼眶内侧壁结构各定量测量参数无统计学差异。在相近外力作用下,筛窦气房分隔数越少,单位分隔所支撑的筛骨纸板面积越大,患者越易发生眶内侧壁骨折。

Objective：To evaluate the role of quantitative measurements of orbital medial wall in the morphology of blow-out fracture based on CT imaging. Methods：Patients with periocular trauma who underwent CT scan from January 2012 to December2014 were reviewed. A hundred patients without orbital fracture and 76 patients with pure orbital fracture（50 medial orbital wall fracture patients and 26 inferior orbital wall fracture patients） were identified. Quantitative measurements of orbital medial wall including anterior height,posterior height,anteroposterior diameter,area of lamina papyracea and number of ethmoid air cell septa,lamina papyracea area / ethmoid air cell septa were compared between groups by independent t-test. Results：There were no significant differences in all measurements between bilateral sides in patients without orbital fractures（P 〉 0.05）,as well as in the anterior height,posterior height,anteroposterior length,and area of lamina papyracea between patients with isolated medial fractures and those with isolated inferior fractures. The number of ethmoid air cell septa was significantly fewer（P=0.013） and lamina papyracea area / ethmoid air cell septa significantly larger（P =0.011） in patients with medial wall fractures compared to those with inferior wall fractures.Conclusion：No significant differences were found in quantitative measurements of orbital medial wall between bilateral sides. Under the similar external force,the patients with fewer ethmoid air cell septa and larger lamina papyracea area / ethmoid air cell septa might be more likely to develop a medial wall fracture in similar external force.