颈静脉球窝高位及其与毗邻结构关系的HRCT研究

A Study of High Jugular Bulb Fossa and the Relationship of Its Adjacent Important Structure Based on HRCT

目的基于高分辨CT评估成人颈静脉球窝(JBF)高位及其与毗邻重要结构的位置关系。方法回顾性分析符合纳入标准的100例(200侧)鼻窦高分辨CT。在多平面重组图像上以鼓环、耳蜗、内听道及外半规管为参照结构评估JBF有无高位;在三维重建图像上分别测量JBF与面神经管乳突段、内听道底、前庭导水管及鼓室间骨壁最短距离;以乙状窦沟为参考结构将乳突气化分Ⅰ～Ⅳ度,比较不同高度、不同气化组间JBF与以上毗邻结构间距离有无差异。结果 JBF达鼓环、耳蜗底转、蜗窗、内听道底、外半规管者分别占82.0%、38.5%、27.0%、15.5%、2.5%;与面神经管乳突段、内听道底、前庭导水管、鼓室间平均距离分别为(5.87±2.76)mm、(6.63±2.51)mm、(5.79±3.62)mm、(4.06±3.01)mm;与以上结构间骨壁缺失者分别占2.5%、0.5%、5.0%、4.5%。JBF与内听道、前庭导水管、面神经管间距离在以各高位参考结构分组时组间差异均有统计学意义;基于各参考结构的JBF高位发生率在不同气化程度组间均无差异;JBF与面神经管乳突段间距在不同气化程度组间差异具有统计学意义。结论 JBF高度及其与毗邻结构位置关系变化较大,疾病评估及制定手术方案时需考虑以上因素的影响。

Objective To evaluate the position relationship of jugular bulb fossa(JBF)and its adjacent important structure based on HRCT.Methods We retrospectively analyzed paranasal sinuses CT scan 100 case(200 side)which were in accordance with the inclusion criteria.In a multi-planar reformation image,we defined high jugular bulb(HJB)by the relationship between the jugular bulb(JB)and annulus tympanicus,cochlea,lateral semicircular canal,the internal auditory canal(IAC).Minimum distances between JBF and mastoid segment of the facial canal,internal acoustic meatus fundus,vestibular aqueduct,tympanic cavity were measure in 3 D reconstruction image.They were classified in four groups,according to the location of the groove of the sigmoid sinus,compared distances of JBF and these adjacent structures in different height and pneumatization groups.Results JBF reached annulus tympanicus,basal turn of the cochlea,fenestra cochleae,lateral semicircular canal and IAC is 82.0%,38.5%,27.0%,15.5%,2.5%.The mean distance with mastoid segment of the facial canal,internal acoustic meatus fundus,vestibular aqueduct,tympanic cavity is(5.87±2.76)mm,(6.63±2.51)mm,(5.79±3.62)mm,(4.06±3.01)mm.Plate dehiscence with the above structures is 2.5%,0.5%,5.0%,4.5%.The mean distance with mastoid segment of the facial canal,internal acoustic meatus fundus,vestibular aqueduct,tympanic cavity showed significant differences in JBF groups with different reference structures.Incidence rate of JBF showed no difference between four pneumatization groups.The distance between JBF and mastoid segment of the facial canal showed significant differences.Conclusion The height of the JBF and position relationship with the adjacent structures are in large variation.The impact of these factors should be taken into account when evaluating disease and developing surgical procedures.