鼻内镜视觉空间内CT影像分析及应用  

Analysis and application of the images from the segmenting CT in the space of nasal endoscope

作　　者：王小路[1] 单希征[1] 高建华[2] 

机构地区：[1]武警总医院耳鼻咽喉头颈外科,北京100039 [2]武警总医院耳鼻咽喉头放射科,北京100039

出　　处：《中华耳鼻咽喉头颈外科杂志》2009年第10期857-860,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：武警总医院院级课题资助项目（WJ2008-009）

摘　　要：目的分析鼻内镜视觉空间内CT影像的变化规律，并探讨其在手术中的应用价值。方法依据15例患者（鼻腔内翻性乳头状瘤5例，慢性鼻-鼻窦炎10例）术前鼻窦冠状位CT扫描数据，以草图大师软件（SkechUp）模拟0°鼻内镜下理想鼻腔，将cT影像放入理想鼻腔的对应空间，依据特定进镜距离和角度，对CT影像中解剖结构（按次序）及空间方向进行观察，拟定手术计划，并与术中所见进行对比。结果内镜空间内CT影像解剖结构的形态及空间方位发生改变，与进镜距离和角度相关，依据特定进镜距离和角度，对内镜空间CT影像解剖（按次序）的分析与术中所见一致，为鼻内镜手术操作提供正确的指导。结论内镜空间内CT影像的变化符合透视规律，对内镜下空间透视规律的认识可把握内镜下正确的方向，提高鼻内镜手术的安全性。内镜空间内CT影像分析方法简单可行，具有一定临床应用价值。Objective To analyze the images from the segmenting CT in the space of nasal endoscope and to observe the benefits in applying the method in endoscopic sinus surgery. Methods Five patients with inverted papilloma and ten patients with chronic rhinosinusitis were enrolled. The images from the coronal CT were put in the ideal model of the nasal cavity, which had been designed by SketchUp software package, and the space of the model in the 0° rod-lens telescope was simulated and observed according to definite elevation angle between the endoscope and bottom of nasal cavity and the distance of the endoscope entering the nasal cavity. The surgical plan was designed and compared with the models of the intraoperative corresponding vision. Results The anatomical form of the images from the coronal CT and the directions of the space in the visual field of the endoscope were correlative with the elevation angle between the endoscope and bottom of nasal cavity and the distance of the endoscope entering the nasal cavity. Based on the elevation angle and the entering distance of the endoscope, the images from the CT scan in the space of nasal endoscope were analysed according to the order, which were consistent with the findings in the intraoperative corresponding vision, providing the accurate directions of the space for the endoscopic sinus surgery. Conclusions The changes of the images of the CT scan in the space of the endoscope were consistent with the perspective law. To know the perspective law could grasp the directions of the space in the visual field of the endoscope and ensure the safety of the endoscopic surgery. The method was simple and feasible. The benefits of this technique were confirmed by clinician.

关 键 词：内窥镜检查 耳鼻喉外科手术 视觉 体层摄影术 X线计算机 

分 类 号：R686[医药卫生—骨科学]