中鼻甲连续冠状位断面解剖及3D数字重建  

Continuous sectional anatomy of the middle turbinate and 3D digital reconstruction

作　　者：栾宁 安凤杨 孙健斌 王玉辉 李丽娟[1] 骆岩林[2] 李涛[1] 朱丽[1] LUAN Ning;AN Feng-yang;SUN Jian-bin;WANG Yu-hui;LI Li-juan;LUO Yan-lin;LI Tao;ZHU Li(Department of Otorhinolaryngology,Peking University Third Hospital,Beijing 100191,China;School of Artificial Intelligence,Beijng Normal University,Beijing 100875,China)

机构地区：[1]北京大学第三医院耳鼻咽喉科,北京100191 [2]北京师范大学人工智能学院,北京100875

出　　处：《解剖学报》2020年第5期637-643,共7页Acta Anatomica Sinica

基　　金：国家自然科学基金(61977603,21705006);科技冬奥2019重点专项(2019YFF0301705)。

摘　　要：目的探讨中鼻甲连续冠状位断面解剖特点,结合薄层CT扫描及3D数字重建,为自后向前的鼻窦手术提供结构解剖学基础。方法4具(8侧)成人尸头标本,行鼻窦螺旋CT扫描获取图像后,行连续冠状位断面解剖,并对相应层面的CT图像进行结构标注,观察中鼻甲3部分的形态学特点及与CT影像的对应关系;通过薄层鼻窦CT进行3D立体数字重建中鼻甲。结果连续冠状位断面解剖自后向前观察中鼻甲各部分形态特点为,中鼻甲水平部内侧游离端为球状并以板状结构附着于鼻腔外侧壁;板状结构向前分为前后骨板,前为筛泡基板,后为中鼻甲基板,斜行向前向上附着于脑板;在筛泡基板与中鼻甲基板之间为前组筛窦;中鼻甲垂直部自中鼻甲水平部以矢状位向上呈扇形附着于额鼻嵴及脑板;以冠状位断面解剖中鼻甲3部分典型形态标注鼻窦CT图像;完成了中鼻甲形态数字三维重建。结论从冠状位断面形态观察,可以归纳出自后至前中鼻甲形态变化规律,为自后向前的手术径路提供解剖学依据。Objective To study the characteristics of continuous coronal sectional anatomy of middle turbinate combined with thin-layer CT scanning and 3D digital reconstruction,so as to provide the structural anatomical basis for the operation of nasal sinus from back to front.Methods Four adult cadaver heads(8 sides)were scanned by spiral CT of the paranasal sinuses,and then dissected in continuous coronal section.The corresponding CT images were labeled to observe the morphological characteristics of the 3 parts of the middle turbinate and the corresponding relationship with CT images.The middle turbinate was reconstructed by 3D three-dimensional digital reconstruction with thin slice CT of the paranasal sinuses.Results The morphological characteristics of the middle turbinate were as follows:the free end of the horizontal part of the middle turbinate was spherical and attached to the lateral wall of the nasal cavity with plate-like structure;The plate-like structure was divided into anterior and posterior bone plates,the former was ethmoidal base plate,the latter was middle nasal methyl plate,and attached to the brain plate obliquely forward and upward;Between the ethmoidal base plate and the middle turbinate base was the anterior ethmoidal sinus;The vertical part of the middle turbinate was attached to the frontal nasal ridge and brain plate in a fan-shaped upward sagittal position from the horizontal part of the middle turbinate;The CT images of the three typical parts of the middle turbinate in the sectional anatomy of the coronal position were marked;The three-dimensional reconstruction of the middle turbinate is completed.Conclusion The morphological changes of the posterior to anterior middle turbinate can be concluded from the observation of the sectional morphology of the coronal position,which provides the anatomical basis for the operation route from the posterior to the anterior.

关 键 词：中鼻甲 连续冠状位断层解剖 高分辨率CT 3D数字重建 鼻内镜手术 人 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]