前颅底外伤性脑脊液鼻漏的CT诊断及手术治疗  

CT Diagnosis and Operation Treatment of the Anterior Skull Base Traumatic Cerebrospinal Fluid Rhinorrhea

作　　者：滕问天 李清水[2] 张伟恒 卢家章[3] 

机构地区：[1]广东省中山市古镇医院放射科,广东中山528421 [2]广东医学院附属陈星海医院放射科,广东中山528415 [3]广东医学院附属陈星海医院脑外科,广东中山528415

出　　处：《临床医学工程》2013年第5期513-515,共3页Clinical Medicine & Engineering

摘　　要：目的探讨螺旋CT及重建影像对前颅底外伤性脑脊液鼻漏的诊断价值和合适的前颅窝重建漏口治疗鼻漏的手术方式。方法 12例经临床诊断为脑脊液鼻漏患者,先经螺旋CT扫描,后在工作站上进行三维重建,显示前颅窝骨折和漏口位置、形态;在三维联动图像上显示漏口与副鼻窦之间的关系,对漏口的大小及窦腔的容积进行了测量;依据CT影像资料,对患者进行了手术治疗。结果 CT影像可以明确显示外伤性前颅底脑脊液鼻漏的位置、数量和破损形态;三维联动重建影像并能显示破口与副鼻窦之间的关系,为指导手术提供了影像学依据。"三明治"式样的前颅底重建修补方法可临床治愈脑脊液鼻漏,术后未见复发。结论螺旋CT对颅前窝脑脊液鼻漏有重要的诊断价值,为指导手术方式提供了一定的影像学依据。"三明治"式样的前颅底重建修补方法可临床治愈脑脊液鼻漏。Objective To investigate the diagnostic value of spiral CT and reconstruction image, and explore the operation mode of reconstruction in the anterior skull base for the treatment of rhinorrhea. Methods Twelve cases of patients clinically diagnosed as cerebrospinal fluid rhinorrhea were first examined by spiral CT scanning and then the three-dimensional reconstruction in workstation displayed the anterior cranial fossa fractures, the leak location and the forms. The relationship between leakage and paranasal sinuses was shown in the three-dimensional linkage image. The leak size and the volume of sinus cavity were measured. Guided by these CT image data, the patients were treated with operations. Results CT images clearly displayed the morphological damage of traumatic anterior skull base of cerebrospinal fluid rhinorrhea, number and position of skull base. Three-dimensional reconstruction linkage images displayed the relationship between the break and the paranasal sinus, guiding operations with the imaging basis. The anterior skull base reconstruction and repair methods, named as ＂sandwich style＂, could cure the patients with cerebrospinal fluid rhinorrhea, without any recurrence. Conclusions The spiral CT imaging is valuable for the diagnosis of anterior cranial fossa cerebrospinal fluid rhinorrhea, as it provides certain imaging bases for guiding the operation. The anterior skull base reconstruction and ＂sandwich style＂ repair methods be the options for treatment of cerebrospinal fluid rhinorrhea.

关 键 词：体层摄影 X线计算机 图像处理 计算机辅助 脑脊液鼻漏 颅底重建术 颅脑手术 

分 类 号：R765.24[医药卫生—耳鼻咽喉科]