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[多层螺旋计算机断层扫描对成人蝶窦变异的研究]

[Study of variations in adult sphenoid sinus by multislice spiral computed tomography].

作者信息

Li Shu-ling, Wang Zhen-chang, Xian Jun-fang

机构信息

Department of Medical Imaging Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2010 Aug 17;90(31):2172-6.

Abstract

OBJECTIVE

Explore the anatomic variations of adult sphenoid sinus and delineate the precise relationship between sphenoid sinus and adjacent structures.

METHODS

Using multi planner reformation (MPR), the images of 260 spiral computed tomography (CT) scans were reviewed through a doctor station.

RESULTS

The sphenoid was divided into 6 types: no development, conchal, pre-sellar, half-sellar, full-sellar and post-sellar. The prevalence was 0.19%, 1.54%, 8.08%, 22.88%, 20.58% and 46.73% respectively. And there was no difference between left and right. The prevalence of accessory septa or bone spur inside sphenoid sinus was 51.5%. With the gasification spreading, the prevalence was rising. And there was statistical significance among them. The dorsum sella was divided into three types: I, II, III. And its prevalence was 48.08%, 25.19% and 26.73% respectively. The difference of sphenoethmoid distribution among the various type sinus had no statistical significance. The prevalence of vidian canal and foramen rotundum protrusion was 39.2% and 15.8% respectively. And all occurred in pterygoid process cells. Internal carotid artery (ICA) was divided into 4 types. And the prevalence of type 0 to 3 was 13.5%, 50.0%, 26.9% and 9.6% respectively. With the gasification spreading, the prevalence of types 2, 3 was rising. And there were statistical significance among them. The prevalence of type 0 to 4 CNII was 4.4%, 19.2%, 26.0%, 29.0% and 21.4% respectively. With the gasification spreading, the prevalence of type 3, 4 CNII was rising. And the difference had statistical significance.

CONCLUSION

MPR and multislice spiral CT can facilitate a precise study of anatomic variations in adult sphenoid sinus and delineate the relationships between sphenoid sinus and adjacent structures. Caution must be exercised during sphenoid and trans-sphenoid surgery to minimize the risk of inadvertently injuring the adjacent structures.

摘要

目的

探讨成人蝶窦的解剖变异,明确蝶窦与相邻结构之间的精确关系。

方法

利用多平面重组(MPR),通过医生工作站回顾260例螺旋计算机断层扫描(CT)图像。

结果

蝶窦分为6种类型:未发育型、鼻甲型、鞍前型、半鞍型、全鞍型和鞍后型。其发生率分别为0.19%、1.54%、8.08%、22.88%、20.58%和46.73%。左右侧之间无差异。蝶窦内副隔或骨嵴的发生率为51.5%。随着气化扩展,发生率升高。且它们之间存在统计学意义。鞍背分为三种类型:Ⅰ型、Ⅱ型、Ⅲ型。其发生率分别为48.08%、25.19%和26.73%。不同类型蝶窦中蝶筛分布的差异无统计学意义。翼管和圆孔突出的发生率分别为39.2%和15.8%。且均发生在翼突气房。颈内动脉(ICA)分为4种类型。0至3型的发生率分别为13.5%、50.0%、26.9%和9.6%。随着气化扩展,2、3型的发生率升高。且它们之间存在统计学意义。Ⅱ至Ⅴ对脑神经0至4型的发生率分别为4.4%、19.2%、26.0%、29.0%和21.4%。随着气化扩展,Ⅲ、Ⅳ对脑神经3、4型的发生率升高。且差异有统计学意义。

结论

MPR和多层螺旋CT有助于精确研究成人蝶窦的解剖变异,明确蝶窦与相邻结构之间的关系。在蝶窦和经蝶窦手术过程中必须谨慎操作,以尽量减少无意中损伤相邻结构的风险。

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