用高分辨率CT鉴别鼻骨孔与鼻骨骨折  

The differentiation of the nasal bone foramens and the fractures of nasal bone with high-resolution CT

作　　者：张琳[1] 万业达[1] 李宝玖 何岸苇[1] 何珍[1] 傅菲[1] 孙东辉[1] 刘竟艳[1] 齐扬[1] 祁吉[2] 

机构地区：[1]天和医院放射科,天津300050 [2]天津医科大学第一中心医院放射科

出　　处：《中华放射学杂志》2008年第4期359-362,共4页Chinese Journal of Radiology

摘　　要：目的探讨鼻骨孔与鼻骨骨折的影像学表现及其鉴别要点。方法选取30个干颅标本（60个鼻骨）进行肉眼观察（标本观察组）及CT扫描加容积再现（VR）重组（标本影像组），分别统计孔状鼻骨孔的阳性率、大小、形态及位置，并将两组结果进行配对Χ^2检验。对临床高度怀疑鼻骨骨折的30例患者（病例组），分析鼻骨骨折与鼻骨孔的影像表现。结果标本观察组孔状鼻骨孔出现40例，标本影像组孔状鼻骨孔出现37例。病例组非螺旋横断层面高分辨扫描诊断单发骨折19例，采用多平面重组（MPR）结合VR方法诊断，8例为单发骨折，5例为多发骨折，4例为鼻骨孔，2例为鼻骨下缘正常变异；非螺旋横断层面高分辨扫描诊断多发骨折11例，采用MPR结合VR方法诊断，6例为多发骨折，5例为单发骨折。标本观察组和标本影像组孔状鼻骨孔阳性率分别为66．7％（40／60）和61．7％（37／60），经配对Χ^2检验两组孔状鼻骨孔阳性概率差异无统计学意义（Χ^2=1．33，P〉0．05）。结论鼻骨孔为鼻骨上正常解剖结构，认识鼻骨孔及其影像表现，可以提高鼻骨骨折诊断的正确率，减少误诊率。Objective To study the CT features of nasal bone foramen and nasal bone fracture, and investigate the differential key points of them. Methods visual observation was performed for 30 selected skull specimens of adults（60 nasal bones）（ specimens group）,then CT imaging was obtained for them with volume redering （VR） reconstruction （imaging group）. The frequency of the nasal bone foramens, their size, shape and location were statistical analysed. Ferthermore, CT features of nasal bone foramen and nasal bone fracture were analyzed in 30 patients who were suspected having nasal bone fractures by clinicians. Results Forty foramen shape nasal bone foramens were found in observation group, while 37 were obtained in imaging group. For patients, 19 cases were diagnosed as single fracture of nasal bone by non-spiral axial high-resolution CT images. When using both axial and multi-plane reformation （MPR） and VR images, 8 of 19 cases were diagnosed as single fracture, 5 were multiple fractures, 4 were normal nasal bone foramen, and 2 were normal variation. The other 11 cases that were diagnosed as multiple fractures by non-spiral axial HRCT images were demonstrated as 6 cases multiple fractures and 5 single fracture by combining axial images with MPR and VR images. The frequencies of foramen shape nasal bone foramen in specimens group and imaging group were 66. 7% and 61.7% ,respectively, and there were no significant differences between them （Χ^2 = 1.33, P 〉 0. 05 ）. Conclusion The nasal bone foramen is the normal anatomy, and to recognize the imaging findings of it can improve the diagnostic accuracy of nasal bone fracture.

关 键 词：鼻骨 骨折 体层摄影术 X线计算机 

分 类 号：R686[医药卫生—骨科学]