本文選題：面神經(jīng)管 + CT��； 參考：《新鄉(xiāng)醫(yī)學院》2015年碩士論文

【摘要】：背景面神經(jīng)是最容易發(fā)生神經(jīng)麻痹的腦神經(jīng)之一,大多數(shù)面神經(jīng)麻痹導致的面癱均位于顳骨內(nèi),且與面神經(jīng)管結(jié)構(gòu)密切相關。導致面神經(jīng)管的骨質(zhì)改變的病變有外傷、先天性畸形、膽脂瘤以及腫瘤累及面神經(jīng)管等,影像學資料是客觀準確的診斷依據(jù)。螺旋CT具有強大的三維重建功能,如多平面重組(MPR)和曲面重組(CPR)等,特別是螺旋CT對骨性結(jié)構(gòu)的良好顯示能力,使面神經(jīng)管結(jié)構(gòu)在CT影像上能夠清晰、完整地顯示。目的利用螺旋CT圖像后處理的多平面重組(MPR)和曲面重組(CPR)技術,觀測面神經(jīng)管及面神經(jīng)的迷路段、前膝部、水平段、后膝部和垂直段的位置、形態(tài)、徑線、角度,以及面神經(jīng)管膝狀窩的徑線和面神經(jīng)管垂直段與周圍結(jié)構(gòu)的距離,為面神經(jīng)管病變的臨床診斷提供形態(tài)學依據(jù)。材料與方法收集新鄉(xiāng)醫(yī)學院第三附屬醫(yī)院2013年1月至2014年12月期間,施行耳顳部多層螺旋CT掃描的成年檢查者影像200例,無耳部、顳骨、顱底部畸形和經(jīng)臨床檢查均無面神經(jīng)癱瘓者,其中男性100例,女性100例,年齡21-60歲；經(jīng)影像檢查和手術證實分別確診為面神經(jīng)管骨折、中耳膽脂瘤和面神經(jīng)瘤的影像資料各20例,年齡23-57歲。將被檢查者的原始影像數(shù)據(jù)輸入CT三維重建工作站,使用ADW 4.2重建軟件的多平面重組(MPR)和曲面重組(CPR)技術,分別沿面神經(jīng)管進行圖像后處理,顯示出面神經(jīng)管各段結(jié)構(gòu)的全程。使用三維重建工作站內(nèi)的測量軟件,測量面神經(jīng)管各結(jié)構(gòu)的徑線和角度等。采用SPSS13.0軟件對所得數(shù)據(jù)進行統(tǒng)計學處理,采用均數(shù)±標準差(x±s)表示。結(jié)果1.面神經(jīng)管的多平面重組(MPR)斜軸位影像可以清晰顯示面神經(jīng)管的迷路段、前膝部和水平段的起始部,斜矢狀位影像可以清晰顯示面神經(jīng)管的水平段、后膝部和垂直段。多平面重組(MPR)影像的左右側(cè)、男女性和影像與標本之間均無顯著性差異(P0.05),迷路段、水平段、垂直段的長度和寬度以及前膝部、后膝部的角度分別為(3.66±0.39) mm、(11.50±1.06) mm、(13.68±1.05) mm 和 (0.89±0.14) mm、(1.10±0.11) mm. (1.10±0.14) mm, (71.88±7.98)°、 (110.10±6.13)°。2.面神經(jīng)管的曲面重組(CPR)橫軸位、冠狀位、矢狀位影像均可以清晰顯示面神經(jīng)管的全程。橫軸位的迷路段寬度和后膝部角度與冠狀位、矢狀位之間存在顯著性差異(P0.05),橫軸位、冠狀位、矢狀位的前膝部角度之間均存在顯著性差異(P0.05),橫軸位、冠狀位的水平段寬度和垂直段寬度與矢狀位之間均存在顯著性差異(P0.05)。3.多平面重組(MPR)與曲面重組(CPR)影像的面神經(jīng)管的迷路段長度、迷路段寬度、垂直段長度、垂直段寬度均無顯著性差異(P0.05),前膝部角度、水平段長度、水平段寬度、后膝部角度均存在顯著性差異(P0.05)。4.多平面重組(MPR)面神經(jīng)管膝狀窩徑線長度的A線、B線、C線、D線、E線的正常組與骨折組之間均存在顯著性差異(P0.05),正常組徑線分別為(2.88±0.32)mm、(3.29±0.27)mm、(1.63±0.18)mm、(1.67±0.18)mm、(3.26±0.29) mm,骨折組的徑線均明顯大于正常組。5.面神經(jīng)管垂直段分別至男、女性的外耳道后壁、外耳門后緣、乙狀竇溝前壁、面隱窩的距離之間均存在顯著性差異(P0.05),男、女性分別為(3.07±0.86) mm、(12.07±2.94) mm、(8.35±2.23) mm、(1.89±0.35) mm 和 (2.86±0.61) mm、 (10.49±2.65) mm、(7.68±2.03) mm、(1.74±0.36) mm。結(jié)論1.面神經(jīng)管的多平面重組(MPR)、曲面重組(CPR)CT影像可以直觀顯示面神經(jīng)管,對判斷面神經(jīng)管發(fā)育異常、骨折和腫瘤侵犯面神經(jīng)管等提供了重要的影像解剖學資料。2.面神經(jīng)管膝狀窩的多平面重組(MPR)徑線測量,為膝狀窩擴大可作為膝狀窩骨折的診斷指標提供了客觀依據(jù)。3.面神經(jīng)管垂直段與周圍結(jié)構(gòu)距離的測量,確定了面神經(jīng)管在顳骨內(nèi)的位置,為面神經(jīng)病變減壓手術等提供了定位面神經(jīng)管的方法。
[Abstract]:The background facial nerve is one of the most prone nerve palsy. Facial paralysis caused by most facial paralysis is located in the temporal bone and is closely related to the structure of the facial nerve canal. The lesions of the facial nerve canal include trauma, congenital malformation, cholesteatoma, and swelling of the facial nerve canal. The imaging data are objective. The diagnostic basis. Spiral CT has powerful three-dimensional reconstruction functions, such as multiplane recombination (MPR) and surface recombination (CPR), especially the good display ability of spiral CT to bone structure, so that the facial nerve tube structure can be clearly and completely displayed on the CT image. Objective to use the post-processing of multiplanar recombination (MPR) and surface recombination with spiral CT images. (CPR) technology, observation of the labyrinth segment of the facial nerve canal and facial nerve, the position of the anterior knee, the horizontal segment, the posterior knee and the vertical segment, the shape, the diameter line, the angle, the distance between the facial nerve canal geniculate fossa and the distance between the vertical segment of the facial nerve canal and the surrounding structure, and provide the morphological basis for the clinical diagnosis of the facial nerve canal lesions. Materials and methods collect Xinxiang From January 2013 to December 2014 of the Third Affiliated Hospital of Medical College, 200 adult examiners were performed with multi spiral CT scanning of the auricular temporal region. There was no facial nerve paralysis in the ear, the temporal bone, the skull base deformity and the clinical examination, of which 100 cases were male, 100 cases were female, and the age was 21-60 years old. The image data of nerve canal fracture, middle ear cholesteatoma and facial neuroma were 20 cases, aged 23-57 years. The original image data of the examiners were entered into the CT 3D reconstruction workstation. The multiplane recombination (MPR) and surface recombination (CPR) technique of the ADW 4.2 reconstruction software were used to post the image post-processing along the facial nerve tube, showing the nodes of each segment of the facial nerve tube. The measurement software in the three-dimensional reconstruction workstation was used to measure the diameters and angles of each structure of the facial nerve tube. The data were processed with SPSS13.0 software, and the mean number + standard deviation (x + s) was used. The results of the multi plane recombinant (MPR) oblique axis image of the 1. facial nerve tube could clearly show the labyrinth of the facial nerve tube. Segment, the beginning of the anterior and horizontal segments, the oblique sagittal image can clearly display the horizontal segment of the facial nerve canal, the posterior and vertical segments. The left and right sides of the multiplane recombinant (MPR) image have no significant difference (P0.05), the labyrinth segment, the flat segment, the length and width of the vertical segment, the anterior genu and the posterior knee. The angles were (3.66 + 0.39) mm, (11.50 + 1.06) mm, (13.68 + 1.05) mm and (0.89 + 0.14) mm, (1.10 + 0.11) mm. (1.10 + 0.14), (71.88 + 0.14) mm, (71.88 + 11.50) degrees, the transverse axis of the curved surface of the facial nerve canal (CPR), and the coronal and sagittal images could clearly show the whole course of the facial nerve canal. The width of the transverse section of the labyrinth segment and the posterior segment of the transverse axis There was significant difference between the angle of the knee and the coronal position and the sagittal position (P0.05). There were significant differences (P0.05) between the transverse axis, the coronal position and the anterior knee of the sagittal position. The horizontal segment width and the vertical segment width were significantly different between the sagittal and the sagittal positions (P0.05).3. multiplane recombination (MPR) and the surface recombination (CP). R) the length of the labyrinth segment of the facial nerve canal, the width of the labyrinth segment, the length of the vertical segment and the width of the vertical segment had no significant difference (P0.05). The anterior knee angle, the horizontal segment length, the horizontal segment width, the posterior knee angle had significant difference (P0.05) the A line of the length of the geniculate nests of the MPR facial nerve canal, the B line, C line, D line, E line. There were significant differences between the normal group and the fracture group (P0.05). The normal group diameter line was (2.88 + 0.32) mm, (3.29 + 0.27) mm, (1.63 + 0.18) mm, (1.67 + 0.18) mm, (3.26 + 0.29) mm, and the fracture group was significantly larger than that of the normal group.5. facial nerve canal vertical segment, respectively, the posterior wall of the external auditory canal, the posterior edge of the external ear and the anterior wall of the sigmoid sinus. There were significant differences in the distance between the facial recess (P0.05), men and women were (3.07 + 0.86) mm, (12.07 + 2.94) mm, (8.35 + 2.23) mm, (1.89 + 0.35) mm and (2.86 + 0.61) mm, (10.49 + 2.65) mm, (7.68 + 2.03) mm, multiplanar reorganization of neural tube (MPR), and surface recombination (CPR) CT images can be displayed intuitively The facial nerve canal provides important imaging anatomical data for judging the abnormal development of the facial nerve canal, fracture and tumor invasion of the facial nerve canal, and so on. The multiplanar reorganization (MPR) measurement of the.2. facial nerve canal geniculate fossa can be used to provide an objective basis for the diagnosis of the fracture of the geniculate fossa, which provides an objective basis for the vertical and peripheral structures of the.3. facial nerve canal. The measurement of distance determines the location of the facial nerve canal in the temporal bone, and provides a method for locating facial nerve canal for decompression operation of facial nerve diseases.
【學位授予單位】：新鄉(xiāng)醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R651.3

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