经乳突-上鼓室入路面神经手术主要解剖标志的多螺旋CT双斜位多平面重建  

Study of demonstrating main operative mark of transmastiod-epitympanum approach of the facial nerve using double oblique multi-planar reconstruction in multi-slice CT

作　　者：李志海[1] 吕静瑶[1] 陶宝鸿[1] 沈剑敏[2] 张国兵[2] 温熙 蔡志毅[1] 

机构地区：[1]浙江省台州市立医院耳鼻咽喉科,浙江台州318000 [2]浙江省台州市立医院影像科

出　　处：《临床耳鼻咽喉头颈外科杂志》2011年第19期865-868,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：浙江省医药卫生科学研究基金项目(No:2006B143)

摘　　要：目的:探讨利用多螺旋CT双斜位多平面重建技术(MPR),进行经乳突-上鼓室入路面神经手术中涉及的面神经段及定位解剖标志同层重建的可行性及意义。方法:在1具尸头标本上模拟经乳突-上鼓室面神经手术入路,观察面神经暴露的范围及定位解剖标志。利用双斜位MPR,对30具完整的成年国人尸体头颅标本进行经乳突-上鼓室面神经手术入路中涉及到的面神经段及定位解剖标志同层面重建,并对4个不同方位图像同层显示解剖标志的程度进行分级评价。结果:经乳突-上鼓室入路可显露面神经垂直段、面神经锥段、水平全段、膝状神经节和迷路段远端,定位解剖标志有水平半规管、匙突、上鼓室前隐窝。以上解剖标志在双斜位MPR重建图像中可同层显示,显示成功率均为100%,显示程度双斜位均优于横断位、冠状位及矢状位,不同方位图像显示程度差异有统计学意义(P<0.05)。结论:双斜位MPR可清晰同层显示经乳突-上鼓室入路面神经手术中涉及的主要解剖标志,结合手术进路及手术目的,利用双斜位MPR,针对性地进行相关解剖标志的同层重建,能为术者提供更有使用价值的影像学信息。Objective：To explore a method of demonstrating the facial nerve anatomical landmarks under transmastiod and epitympanum approach with multi-slice CT using double oblique multi-planar reconstruction（MPR）.Method：Two temporal bone of a corpse were dissected,under transmastiod and epitympanum approach,to observe the anatomical landmarks of facial nerve.Based on that,the anatomical landmarks of facial nerve under transmastiod and epitympanum approach in 30（60 ears） normal temporal bones of adult corpses were reconstructed using double oblique MPR in multi-slice CT.The achievement ratio was calculated and the differences among transverse plane,coronal plane,sagittal plane and double oblique were compared.Result：The different part of facial nerve,such as mastoid segment,tympanum segment,pyramid segment,geniculate ganglion and the outer labyrinthine segment could be exposed clearly with the main anatomical landmarks,such as horizontal semicircular canal,epitympanifc recess and cochleariform process through transmastiod and epitympanum approach.The image of anatomical landmarks could be showed in the same sectiong by double oblique multi-planar reconstruction.The double oblique multi-planar reconstruction to show the landmarks of facial nerve displaying on the same imaging is better than transverse plane,coronal plane and sagittal plane.The achievement ratio of every section is 100%.Conclusion：Double oblique MPR is a new method to demonstrate anatomical landmarks through transmastiod and epitympanum approach in one slice.Combined with the operative approach and purpose,the reconstructive images with double oblique MPR can provide valuable information for operation.

关 键 词：面神经疾病 手术入路 多平面重建 

分 类 号：R745.12[医药卫生—神经病学与精神病学]