面神经隐窝入路关键手术剖面多层螺旋CT双斜面多平面重组的研究  

Study of demonstrating main operative section of facial recess approach using double oblique multiplanar reconstruction on multislice CT

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

机构地区：[1]浙江省台州市立医院耳鼻咽喉科,318000 [2]浙江省台州市立医院放射科,318000

出　　处：《中华放射学杂志》2012年第1期13-18,共6页Chinese Journal of Radiology

摘　　要：目的探讨双斜面CTMPR重组技术对面神经隐窝进路手术中关键手术剖面涉及到的解剖标志同层显示的可行性及方法。方法在尸体头颅标本上观察面神经隐窝入路手术中涉及到的关键手术剖面及相关解剖标志，利用双斜面MPR重组技术，对30具（60侧）完整的成年国人尸体头颅标本进行关键手术剖面重组，对比手术剖面主要解剖标志观察结果，对4个不同方位图像（横断面、冠状面、矢状面及双斜矢状面）同层显示主要解剖标志的程度进行分级评价。主要手术解剖标志同层显示为100％者记为4级、显示为90％～99％记为3级、显示为80％～89％记为2级、显示70％～79％记为1级，显示〈70％记为0级。对所得资料行x2检验。结果面神经隐窝入路手术中涉及到4层关键手术剖面，均为斜矢状面。4层关键手术剖面双斜面MPR重组的旋转中心标志点分为水平半规管、砧骨窝、锥隆起及圆窗后缘；重组水平参考轴线及水平旋转角度分别为砧骨短突及22．15°±5．22°、砧骨短突及20．15°±5．52°、面神经水平段及32．53°±5．22°、卵圆窗上缘及50．15°±8．02°；重组垂直参考轴线均为面神经垂直段，垂直旋转角度分别为14．35°±4．02°、13．15°±3．33°、15．05。±4．43。及15．25°±4．12°。对于主要解剖标志同层显示的程度，在第1层关键手术剖面中，双斜矢状面为4级60侧，横断面为2级12侧、3级48侧，冠状面为2级15侧、3级45侧，矢状面为3级10侧、4级50侧；第2层关键手术剖面中，双斜矢状面为4级60侧，横断面为2级11侧、3级49侧，冠状面为2级13侧、3级47侧，矢状面为3级11侧、4级49侧；第3层关键手术剖面中，双斜矢状面为4级60侧，横断面为2级10侧、3级50侧，冠状面为2级11侧、3级49侧，矢状面为3级9侧、4级51侧；第4层关键手术剖面中，双斜矢状面为4级60侧，横断面为2级9侧、3级5Objective To explore the method of demonstrating main operative section of facial recess approach with multi-slice CT by using double oblique muttiplanar reconstruction. Methods Similarly as surgical procedure of facial recess approach, 30 （60 eras） normal temporal bones in cadavers were reconstructed to observe main operative sections and anatomical marks. Main images of operative section of facial recess approach were reconstructed using double oblique multiplanar reconstruction on multislice CT. With the reference of operative anatomical marks, the ratios of visibility of anatomical marks on the transverse plane, coronal plane, sagittal plane and double oblique were calculated and compared. The degree, of which major anatomical landmarks were displayed on the same plane （ axial, coronal, sagittal, or double- oblique sagittal plane） , was classified using the following criteria： level 4： 100% of anatomical landmarkswere presented in the same plane; level 3 ： 90% to 99% of anatomical landmarks were presented in the same plane; level 2： 80% to 89% of anatomical landmarks were presented in the same plane; level 1 ： 70% to 79% of anatomical landmarks were presented in the same plane; level 0： 〈 70% of anatomical landmarks were presented in the same plane. Classification data were tested by chi-square test. Results Four key operative section were involved in facial recess approach, which were of oblique sagittal orientation. The central mark of the first key operative section was semicircular canal by using double oblique multi-planar reformation. On reconstructed images of the first key operative section, horizontal reference line was short process of incus, and the angle adjusting the reference line on the transverse plane was 22. 15 ° ± 5.22°. On the reconstructed images of the first key operative section, coronal reference line was tympanic segment of facial canal, and the angle adjusting the reference line on the coronal plane was 14. 35°±4. 02°. On the reconstructed images of the se

关 键 词：颞骨 体层摄影术 X线计算机 解剖学 局部 耳外科手术 

分 类 号：R816.1[医药卫生—放射医学]