能谱CT在窦口鼻道复合体解剖变异中的临床应用  

Clinical application of spectral CT in anatomic variation of ostiomeatal complex

作　　者：赵平 陈清生 蔡吉勇 邵林 陈伟 ZHAO Ping;CHEN Qing-sheng;CAI Ji-yong;SHAO Lin;CHEN Wei(Department of Radiology,Traditional Chinese Medicine of Bishan in Chongqing,Chongqing 402760,China;Department of Radiology,People s Hospital of Bishan in Chongqing,Chongqing 402760,China;Department of Radiology,First Hospital Affiliated to AMU,Chongqing 400038,China)

机构地区：[1]重庆市璧山区中医院放射科,重庆402760 [2]重庆市璧山区人民医院放射科,重庆402760 [3]陆军军医大学第一附属医院放射科,重庆400038

出　　处：《局解手术学杂志》2018年第9期638-642,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：2013年重庆市卫生局医学科研项目(2013-2-266)

摘　　要：目的探讨能谱CT多平面重建对窦口鼻道复合体(OMC)区域解剖变异检查的优势,分析OMC解剖变异与副鼻窦炎的相关性及对临床治疗的应用价值。方法回顾性分析我院2016年1月至2018年5月副鼻窦能谱CT检查的252例患者的临床资料。所有患者均在轴位容积扫描后,行薄层轴位、冠状位、矢状位图像重建,记录OMC发生变异的情况。结果 OMC解剖变异165例(鼻窦炎116例、非鼻窦炎49例),包括钩突偏移95例,钩突肥厚85例,钩突气化21例,中鼻甲气化28例,中鼻甲反向19例,鼻丘过度气化39例,筛泡过度气化45例,Haller气房12例。钩突变异,中鼻甲、鼻丘及筛泡过度气化与慢性副鼻窦炎关系密切。OMC单一变异和混合变异除中鼻甲反向、Haller气房外,均与慢性副鼻窦炎的发生有正相关性。结论能谱CT多平面重建能清晰显示窦口鼻道复合体区解剖变异及变异引起慢性副鼻窦炎的程度、范围,在鼻窦炎患者鼻内镜治疗手术方案制订及术中风险防范具有明显的临床指导意义。Objective To explore the advantages of multiplanar reconstruction（MPR） of spectral CT in the regional anatomical variation of ostiomeatal complex（OMC）,and to analyze the correlation between OMC anatomical variation and paranasal sinusitis and its application value in clinical treatment.Methods The clinical data of 252 patients with spectral CT in our hospital from January 2016 to May 2018 were analyzed retrospectively,after the axial volume scan,thin-axis axial,coronal and sagittal image were reconstructed,record the variation of OMC.Results A total of 165 cases with OMC anatomical variation （116 cases of sinusitis and 49 cases of non-sinusitis） were detected,including 95 cases of uncinate process deviation,85 cases of uncinate hypertrophy,21 cases of necropsy gasification,28 cases of middle turbinate gasification,19 cases of nasal turbinate reverse,39 cases of nasal mound hypergasification,45 cases of bulla ethmoidalis hypergasification and 12 cases of Haller air cells.The statistical results showed that there was a close relationship between chronic paranasal sinusitis and hyperpneumatization of middle turbinate,agger nasi and ethmoidal bulla.Conclusion Multiplanar reconstruction of spectral CT can clearly display the anatomical variation of sinus and nasal passage complex area,the degree and extent of chronic sinusitis caused by anatomic variation,and the correlation between them.It is an important guide for endoscopic treatment of chronic paranasal sinusitis.

关 键 词：窦口鼻道复合体 解剖变异 能谱CT 多平面重建 

分 类 号：R814[医药卫生—影像医学与核医学]