本文選題：蝶竇氣化 + 計(jì)算機(jī)斷層掃描��； 參考：《蘇州大學(xué)》2011年碩士論文

【摘要】：目的:對蝶竇及周圍區(qū)域進(jìn)行CT掃描,在圖像工作站上對蝶竇在冠狀位上氣化程度進(jìn)行分度。在不同氣化程度下,測量與內(nèi)鏡巖尖斜坡區(qū)(簡稱巖斜區(qū))、中顱窩內(nèi)側(cè)區(qū)手術(shù)密切相關(guān)的解剖結(jié)構(gòu)數(shù)據(jù),探討氣化對解剖結(jié)構(gòu)的影響。以期所得結(jié)果對擴(kuò)大內(nèi)鏡顱底手術(shù)有指導(dǎo)意義。 方法:(1)隨機(jī)選擇155例無蝶竇病變成人鼻竇螺旋CT掃描資料,男106例、女49例,年齡18-78歲,掃描層厚0.625mm。在冠狀位圖像上,以經(jīng)翼突內(nèi)、外側(cè)板根分別作相互平行的2條豎線(內(nèi)線、外線)。蝶竇向側(cè)方氣化同這兩條豎線相比較:蝶竇氣化的最外側(cè)界未超越(含達(dá)到)內(nèi)線為Ⅰ度;氣化達(dá)內(nèi)、外線之間為Ⅱ度;氣化超越外線為Ⅲ度。在冠狀位圖像上共測量12組參數(shù)(多與經(jīng)翼突中顱窩手術(shù)入路相關(guān));在軸位圖像上共測量6組參數(shù)(多與經(jīng)翼突巖斜區(qū)入路相關(guān))。(2)采用Centricity DICOM Viewer 3.0軟件進(jìn)行測量,用SPSS16.0軟件對數(shù)據(jù)行單因素方差分析(ANOVA)及非參數(shù)秩和檢驗(yàn)(P0.05)。 結(jié)果:(1)蝶竇側(cè)方氣化程度:Ⅰ度氣化占43%、Ⅱ度氣化占34%、Ⅲ度氣化占23%。(2)在冠狀位上所測量12組參數(shù)中,7組參數(shù)在蝶竇不同氣化程度下存在統(tǒng)計(jì)學(xué)差異;在軸位上測量6組參數(shù)中,2組在蝶竇不同氣化程度下存在統(tǒng)計(jì)學(xué)差異。(3)翼突內(nèi)、外側(cè)板根部之間平均距離為6.31mm(1~11.35mm),其中Ⅰ度氣化6.20±1.83mm,Ⅱ度氣化6.48±1.53mm,Ⅲ度氣化6.27±1.56mm,三組之間方差分析無顯著性差異(X2=0.826,P=0.439)。翼管與圓孔平均距離為6.39mm(1.6~15.3mm),其中Ⅰ度氣化4.99±1.6mm,Ⅱ度氣化6.28±2.13mm,Ⅲ度氣化9.24±1.89mm,三組數(shù)據(jù)之間有顯著性差異(X2=123.108,P0.05)。翼突內(nèi)、外側(cè)板根、翼管、圓孔所圍成的平均面積88.21 mm2 (9.31~232.13 mm2),其中Ⅰ度氣化時面積是75.53±27.42mm2,Ⅱ度氣化時是83.04±31.03mm2,Ⅲ度氣化時是120.33±42.65mm2,三組之間有顯著性差異(X2=45.407,P0.05)。不同氣化分度下,翼管、圓孔被氣腔環(huán)繞的程度的差異有統(tǒng)計(jì)學(xué)意義,且蝶竇側(cè)方氣化程度與翼管、圓孔被氣腔環(huán)繞的程度存在一致性。 結(jié)論:翼突內(nèi)、外側(cè)板是手術(shù)中重要的解剖標(biāo)志。它們與蝶骨體胚胎來源及成骨方式不同,其本身位置受到蝶竇側(cè)方氣化影響較小,故可作為較恒定的、同手術(shù)密切相關(guān)的標(biāo)志來界定氣化程度。蝶竇向側(cè)方氣化程度的變化可以影響同內(nèi)鏡經(jīng)翼突巖斜區(qū)和顱中窩區(qū)域手術(shù)密切相關(guān)的解剖結(jié)構(gòu)的空間位置,本研究所提示的蝶竇側(cè)方氣化程度的改變對解剖結(jié)構(gòu)影響的規(guī)律性可用來指導(dǎo)相關(guān)臨床實(shí)踐。
[Abstract]:Aim: to evaluate the degree of sphenoid sinus vaporization on coronal position by CT scanning in the sphenoid sinus and its surrounding region. Under different degree of gasification, the anatomical data closely related to endoscopic petrous apical slope area and medial area of middle cranial fossa were measured, and the influence of gasification on anatomical structure was discussed. The results are useful for endoscopic skull base surgery. Methods Twenty five adult patients without sphenoid sinus disease were randomly selected for spiral CT scan of paranasal sinuses, 106 males and 49 females, aged 18-78 years, with a slice thickness of 0.625mm. In coronal images, two parallel vertical lines (inner line and outside line) were made by transpterygoid root and lateral plate root respectively. The lateral vaporization of sphenoid sinus is compared with these two vertical lines: the inner line of sphenoid sinus gasification does not exceed (including reaching) the inner line is 鈪，

本文編號：1844302