上颌窦骨性分隔的MSCT表现及临床意义

MSCT features and their clinical significance in maxillary sinus bony septum

目的 探讨上颌窦骨性分隔的MSCT表现及临床意义。方法 回顾性分析我院2014年12月~2015年12月间的92例经MSCT证实的上颌窦骨性分隔患者的CT表现。结果 双侧上颌窦分隔43例,单侧49例;共135个上颌窦,其中部分分隔103个（76.3%）,完全分隔32个（23.7%）,同一鼻窦内多处（≥2）分隔者8个（约占5.9%）;上颌窦分隔分为4类：垂直冠状分隔27个（18.8%）,垂直矢状分隔62个（43.4%）,水平分隔45个（31.5%）,斜行分隔9个（6.3%）;鼻窦分隔腔的开口有分别开口于上、中鼻道、两腔相通开口于中鼻道及一分隔腔闭塞三种情况,四类上颌窦分隔在分隔腔开口情况上各不相同。结论 MSCT薄层骨窗及MPR重建图像能够对上颌窦分隔畸形的存在、分型以及窦腔开口作出准确判断,从而为临床科室正确选择手术适应证和制定手术方案提供可靠的指导依据。

Objective To discuss the MSCT features and their clinical significance in maxillary sinus bony septum. Methods The CT features of 92 patients with maxillary sinus bony septum confirmed by MSCT from December 2014 to December 2015 in our hospital were reviewed. Results A total of 135 maxillary sinuses were inspected. 43 cases were bilateral maxillary sinus bony septum, and 49 cases were unilateral. 103 cases （76.0%） were partially septum, and 32 cases （23.7%） were completely septum. 8 cases （5.9%） had multiple （≥ 2） septa in one paranasal sinus. There were four types of maxillary sinus septum： vertical coronal septum （27 cases, 18.8%）, vertical sagittal septum （62 cases, 43.4%）, horizontal septum（45 cases, 31.5%）, and oblique septum（9 cases, 6.3%）. There were three patterns of the opening of si- nus septum cavity： on the superior and middle nasal meatus respectively, on the middle nasal meatus with connected cavities, and one of the septum cavity was occluded. The opening patterns were different of the four types of maxillary sinus septum. Conclusion Correct diagnosis of maxillary sinus septum and its type and opening pattern can be exam- ined by MSCT thin cut bone window and MPR reconstructed images, thus providing reliable basis for selection of surgi- cal indications and formulation of operation plans.