鼻前棘骨折的高分辨率CT表现

Features of high-resolution CT of anterior nasal spine fracture

目的:探讨鼻前棘的形态特点及其骨折发生率,分析其影像学表现,以提高医师对其认识,减少漏诊。方法:对258例外伤后行颌面部高分辨率CT扫描患者的图像进行三维重组,通过重组图像分析鼻前棘的形态特点及其骨折的影像学表现,并统计骨折发生率、漏诊率及与鼻骨骨折的关系。结果:258例中,鼻前棘为双杆型(Ⅰ型)109例,单杆型(Ⅱ型)39例,三角型(Ⅲ型)74例及不规则型(Ⅳ型)36例。共检出鼻前棘骨折40例,发生率约15.5%(40/258);其中Ⅰ型77.5%(31/40),Ⅱ型15.0%(6/40),Ⅲ型2.5%(1/40),Ⅳ型5.0%(2/40)。87.5%(35/40)的鼻前棘骨折合并鼻骨骨折。结论:颌面部外伤患者可伴鼻前棘骨折,影像医师要加强认识,减少漏诊,借助MSCT高分辨扫描联合三维重组可明确诊断,为面部整形外科学及法医学提供帮助。

Objective:To investigate the morphological characteristics and fracture incidence of the anterior nasal spine,and to analyze the imaging features in order to improve the awareness of it.Methods:The maxillofacial high-resolution CT images of 258 patients with trauma were retrospectively analyzed,and 3D reconstruction was performed.The morphological characteristics and imaging findings of fracture of anterior nasal spine were analyzed,and the fracture incidence and the rate of missed diagnosis of the anterior nasal spine and their relationships with fracture of nasal bone were statistically analyzed.Results:258 patients showed different types of morphology of anterior nasal spine,109 were typeⅠ,39 were typeⅡ,74 were typeⅢ,36 were typeⅣ.A total of 40 cases of anterior nasal spine fracture were detected,with the fracture incidence of 15.50%(40/258).The fracture incidence of anterior nasal spine was 77.50%(31/40)for typeⅠ,15.00%(6/40)for typeⅡ,2.50%(1/40)for typeⅢ,5.00%(2/40)for typeⅣ,respectively.Fracture of anterior nasal spine combined with nasal bone fracture accounted for 87.50%(35/40).Conclusions:High-resolution CT combined with 3D reconstruction can better display the anatomical structure of the anterior nasal spine,accurately diagnose the fracture of the anterior nasal spine,reduce missed diagnosis,and also provide help for facial plastic surgery and forensic medicine.