先天性颅颌面骨常见畸形的MSCT诊断

The MSCT diagnosis of common congenital craniofacial deformity

目的:总结先天性颅颌面骨常见畸形的多层螺旋CT(MSCT)表现,提高诊断水准。方法:回顾性分析40例先天性颅颌面骨畸形的MSCT征象。结果:颅面裂畸形共14例,MSCT示均累及唇腭部,表现为上唇部唇弓区软组织崩裂伴邻近硬腭部骨质缺损,鼻中隔明显偏曲,9例同时伴有颌骨发育不良或偏颌畸形;半面短小症共7例,均累及单侧颅面部,MSCT示患侧下颌骨髁突、下颌支短小变细,耳廓、咬肌缩小并周围脂肪间隙变薄,下颌骨位置上移及左右面部不对称;眶距增宽症共9例,MSCT示两眼眶内侧间骨性距离增宽,双侧眶外壁夹角和视神经夹角增大伴眼球突出,鼻外形宽大扁平并软组织增厚,筛窦横径增宽、窦腔扩大伴过度气化,鼻甲肥大、颧面部骨质肥厚外凸及间距增宽;颅缝早闭症共10例,MSCT示颅骨不规则状突出,其中5例头颅向一侧倾斜,3例头颅呈舟状,2例头颅前部呈三角状,7例同时伴有颅板多发指压迹样改变。结论:各型先天性颅颌面骨常见畸形均具有典型的影像学征象,多层螺旋CT及其三维成像能清晰显示颅颌面骨畸形的特征性表现,能为临床诊断及治疗提供帮助。

Objective：To investigate the MSCT（multi-slice computed tomography）findings of common congenital craniofacial deformity.Methods：The MSCT features of 40 patients with common congenital craniofacial deformity were analyzed retrospectively.Results：There was congenital craniofascial cleft in 14 cases.MSCT showed involvement of lip and palate in all cases,presenting as crack of soft tissue of the upper lip bow area and bone defect of hard palate with obvious deviation of nasal septum in all 14 cases,dysplasia and deformity of jaw occured in 7cases.There was hemifacial microsomia in 7cases.MSCT findings included shortening and thinning of mandibular condyle and mandibulae branch（n=7）,shrinking of auricle and masseter muscle with fat space narrowing（n=7）,upward deviation of mandible and facial asymmetry（n=7）.These was 9cases with orbital hypertelorism（n=9）,MSCT showed increase of bony distance between both orbits（n=9）,increase of the angle of the orbital wall and the optic nerve（n=9）,thickening of the nasal soft tissue（n=9）,widenning sinus and expansion of sinus cavity（cells）with excessive pneumatization（n=9）,turbinate hypertrophy,zygomatic facial bone hypertrophy and convex hypertelorism（n=9）.Craniosynostosis occured in 10 cases.MSCT findings included irrgular skull（n=10）,inclined head（n=5）,boat shaped skull（n=3）,triangular shape in anterior part of the skull（n=2）,multiple finger-prints on inner cranial plate（n=7）.Conclusion：Congenital craniofacial deformity had some typical MSCT features.To summarize the features was helpful for the diagnosis and therapy of this disease.