经鼻蝶入路行斜坡区手术蝶窦斜坡隐窝的CT评价  

Evaluation of the Clival Recess with CT in Transsphenoidal Approach to Clival Region

作　　者：朱友余[1] 方琼[1] 陶冶 杨见明 刘斌 张子轩[1] 邓雪飞[1] 

机构地区：[1]合肥安徽医科大学人体解剖学教研室,安徽230032 [2]第二附属医院耳鼻喉科 [3]第一附属医院放射科

出　　处：《解剖与临床》2013年第6期451-454,共4页Anatomy and Clinics

基　　金：国家自然科学基金（81200895）

摘　　要：目的：通过对经鼻蝶人路行斜坡区手术斜坡隐窝的CT评价，为术前手术入路的设计提供影像学依据。方法：93例患者行头颅螺旋CT扫描，多平面重建后，在正中矢状面上，根据蝶窦、斜坡和垂体的位置关系，评价斜坡隐窝并对其进行分型，比较不同分型患者斜坡不同位置厚度的差异。结果：本组斜坡隐窝出现率为65％（60／93）。该隐窝位于蝶鞍下方（鞍下型）、伸入鞍后（鞍后型）或枕骨基底部（枕型）者分别占13％（12／93）、29％（27／93）和23％（21／93）。无斜坡隐窝型蝶窦共33例（35％），其斜坡各部分均较其它类型蝶窦厚；枕型和鞍后型斜坡隐窝的斜坡上部、中部较其它类型蝶窦薄，枕型蝶窦的斜坡下部较其它类型蝶窦薄。结论：术前利用螺旋CT对斜坡隐窝进行评价有助于经鼻蝶入路行斜坡区手术人路的设计。Objective：To evaluate the elival recess with CT, in order to provide a basis for the design of traussphenoidal approach to elival region. Methods： A total of 93 patients were performed thin head scan with 64 - slice spiral CT, and the media sagittal images were reconstructed in AW 4.2 workspace. The classifi- cation of clival recess was determined by the position relation between sphenoid sinus, clivus and hypophysis. The thickness in different part of clivus was compared between various types of clival recess. Results ： The inci- dence of clival recess was 65% （60/93）, which the sphenoid sinus were expanded to posterior edge of the hy- pophysis. The incidence of elival recess expanded below the sella tureica （ subdorsum type） , posterior to the sella turcica （dorsum type）, or into the base part of occipital bone （occipital type） was 13% （12/93）, 29% （27/93）, and 23% （21/93） respectively. The clivus in the patients which the clival recess did not exist was thicker than other types. The upper and middle part of clivus in dorsurn type and occipital type were thinner than other types. The lower part of clivus in the occipital type was thinner than other types. Conclusions ： The e- valuation of clival recess with CT is useful to design the individualized transsphenoidal approach to clival re- gion.

关 键 词：经鼻蝶入路 蝶窦 斜坡隐窝 螺旋CT 

分 类 号：R816.1[医药卫生—放射医学] R322.8[医药卫生—临床医学]