上颌窦动脉解剖结构的锥形术计算机断层扫描分析  

Cone-beam CT analysis of anatomical structure of maxillary sinus arteries

作　　者：吴炯睿 高益鸣[1,2] WU Jiongrui;GAO Yiming(Department of Stomatology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Shanghai Jiao Tong University School of Stomatology,Shanghai 200125,China)

机构地区：[1]上海交通大学医学院附属瑞金医院口腔科,上海200025 [2]上海交通大学口腔医学院,上海200125

出　　处：《上海交通大学学报（医学版）》2023年第2期201-207,共7页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的·通过锥形术计算机断层扫描(cone-beam CT,CBCT)测量分析上颌窦动脉解剖结构。方法·对1021例因牙列缺损或缺失至上海交通大学医学院附属瑞金医院行种植手术患者的双侧上颌窦中的上颌窦动脉(maxillary sinus artery,MSA)进行观测。在CBCT骨窗视图,测量第二前磨牙(P2)、第一磨牙(M1)、第二磨牙(M2)牙位中线处MSA骨孔与骨壁间的位置关系,并将其走形类型分为窦内型(位于上颌窦黏膜下方)、骨内型(完全位于上颌窦侧壁内)、表浅型(位于上颌窦外侧壁骨膜下方)3类;测量MSA骨孔直径(diameter of the MSA,DMSA)、MSA骨孔下缘至上颌窦底距离(distance between the lower margin of the vessel and the sinus floor,DVSF);测量M1牙位中线处上颌窦底上方5 mm处的上颌窦侧壁厚度及上颌窦宽度;测量上颌窦底上方10 mm处上颌窦内外侧壁与上颌窦底最低点形成的角度,即上颌窦角度。对不同性别、不同年龄患者的MSA走形位置变异、走形类型、DMSA和DVSF的差异进行统计分析。同时分别对MSA的DMSA及DVSF与上颌窦侧壁厚度、上颌窦宽度、上颌窦角度之间的相关性进行统计分析。结果·①MSA走形位置变异:在1021例患者中,共42例(4.1%)患者的MSA走形于上颌窦侧壁、紧贴上颌窦底部,其中14例(33.3%)为双侧MSA,28例(66.7%)为单侧MSA;7例(0.7%)患者的MSA走形于上颌窦底根方牙槽骨内,其中1例(14.3%)为双侧MSA,6例(85.7%)为单侧MSA。②MSA走形类型:窦内型占36.5%,骨内型占60.4%,表浅型占3.1%。中年患者中骨内型检出率(63.0%)高于青年和老年患者(P=0.005)。③DMSA:M1牙位的DMSA最大,为(1.42±0.44)mm。男性在P2、M1、M2牙位的DMSA均大于女性。在P2、M1牙位均发现上颌窦侧壁厚度与DMSA呈弱正相关(r=0.2,r=0.2)。在M1牙位发现上颌窦宽度、上颌窦角度均与DMSA呈弱负相关(r=-0.1,r=-0.2)。④DVSF:自M2至P2方向,DVSF逐渐降低。男性在P2、M2牙位的DVSF均大于女性。在M1牙�Objective·To analyze the anatomical structural characteristics of maxillary sinus artery(MSA)by cone-beam CT(CBCT)measurement.Methods·The MSAs in the bilateral maxillary sinuses were observed in 1021 patients who went to Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,for implant surgery due to dentition defect or loss.In the CBCT bone window view,the position between the MSA foramen and the bone wall at the midline of the second premolar(P2),the first molar(M1),and the second molar(M2)was measured,and the intrasinus(the artery was located below the mucosa of maxillary sinus),intraosseous(the artery was completely located in the lateral wall of maxillary sinus),and superficial(the artery was located below the periost of the lateral wall of maxillary sinus)types of their location were classified.The distance between the upper and lower edges of the MSA foramen was measured as the diameter of the artery(DMSA).The distance between the lower margin of the vessel and the sinus floor(DVSF)was measured.The lateral wall thickness of maxillary sinus and the width of maxillary sinus at 5 mm above the maxillary sinus floor at the middle line of the M1 tooth position were measured,and the angle formed by the internal and external side walls of maxillary sinus at 10 mm above the lowest point of maxillary sinus floor was measured.The differences of variability of MSA position,MSA shape type,DMSA and DVSF in patients of different genders and ages were statistically analyzed.At the same time,the correlation between DMSA and DVSF of MSA and the lateral wall thickness,width and angle of maxillary sinus were statistically analyzed.Results·①Variability of MSA position:In the 1021 patients,42 patients(4.1%)had MSA located at the lateral wall of the maxillary sinus and close to the maxillary sinus floor,of which 14 patients(33.3%)had bilateral MSA,and 28 patients(66.7%)had unilateral MSA.Seven patients(0.7%)had MSA located in the alveolar bone below the maxillary sinus floor,of which 1 case(14.3%)had MSA located

关 键 词：上颌窦动脉 锥形术计算机断层扫描 上颌窦底提升术 解剖变异 

分 类 号：R782.1[医药卫生—口腔医学]