MSCT在鼻骨新旧骨折及正常细微结构中的鉴别诊断

MSCT diagnosis of old and new fractures and normal mcrostructure of nasal bone

目的探讨高分辨MSCT在鼻骨新旧骨折及正常细微结构中的鉴别诊断,为临床治疗提供重要信息。方法选取我院收治的302次鼻部外伤检查的影像资料,分析MSCT的表现特点、临床症状及相关既往影像检查图像,总结影像及临床的相关性。结果302次检查中包含265例患者,212次确诊为鼻骨骨折,包括新鲜骨折162次、陈旧骨折50次,其中13次陈旧骨折初诊误诊为新鲜骨折;265例患者中包括鼻骨缝变异6例,缝间骨9例,鼻骨孔215例,鼻骨内侧面血管神经压迹9例,鼻骨末端呈驼峰或鹰嘴状26例;其中3例缝间骨、5例鼻骨孔、1例鼻骨末端驼峰状改变初诊误诊为鼻骨骨折。结论掌握鼻区正常细微解剖结构的位置、形态和变异,通过MSCT的MPR及VR图像能较好的与鼻骨骨折相区分;通过认真判读骨折断端形态特征、邻近鼻区软组织和鼻粘膜是否肿胀来区分鼻骨新鲜骨折与陈旧骨折。

Objective To investigate the diagnostic value of high-resolution MSCT in fresh and old nasal bone fractures and normal fine structures so as to provide a reliable basis for clinical treatment.Methods We collected CT data on 302 cases of nasal trauma examination,analyzed the characteristics of MSCT,clinical manifestations and related past examination data.The imaging and clinical relevance was summarized.Results Of the 302 cases for 265 patients,212 cases were diagnosed as nasal fractures,including 162 fresh fractures and 50 old fractures,13 old fractures were misdiagnosed as fresh fractures for the first examination.For the 265 patients,6 cases were variation of nasal suture,9 cases were wormian bone,215 cases were nasal bone hole,9 cases were intranasal vascularnerve imprint.26 cases were hump or eagle-mouthed tip of the nasal bone end,including 3 cases of wormian bone,5 cases of nasal foramen and 1 case of hump at the end of nasal bone was misdiagnosed as nasal bone fracture.Conclusion Mastering the position,shape and variation of normal fine anatomical structures in the nasal region andusing of MPR and VR images of MSCT is able to distinguish nasal bone fractures effectively.Fresh and old fractures of the nasal bone are distinguished by the morphological characteristics of the broken end of the fracture,the swelling of the soft tissue of the adjacent nasal area and the nasal mucosa.