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目的 探讨螺旋CT三维重建图像在鼻腔、鼻窦中的应用价值。方法 上颌窦骨折38例,眶骨、筛窦骨折6例,下颌骨骨折4例,鼻骨骨折2例,额窦骨折2例;慢性鼻窦炎鼻息肉30例;鼻腔鼻窦肿瘤10例。所有骨折病例均用表面遮盖显示法重建出鼻腔窦骨壁表面情况,其余病例均用此法行空气表面投影法处理,重建出气道空腔表面情况,同时行仿真内窥镜成像和多平面重建。三维重建图像分别与原始冠状或轴位图、纤维内窥镜所见及手术所见对照。结果 (1)38例上颌窦骨折情况骨表面重建图与原始冠状或轴位图显示一致,与手术所见相符。(2)慢性鼻窦炎鼻息肉30例和鼻腔鼻窦肿瘤10例,空气表面投影法重建图像能清楚地显示含气腔和气道狭窄和堵塞情况,类似空气造影,所显示的病变范围大小与手术所见一致。(3)仿真内窥镜成像分别从前从后(足)端入路观察,可清楚地显示鼻腔内各结构及病变,与纤维内窥镜和手术所见描述基本一致。(4)多平面重建图像清晰,分辨率高,比冠状或轴位原始图,对窦口鼻道复合体等正常解剖结构,肿瘤和鼻息肉的位置、形态、及周围组织关系显示更清楚。结论螺旋CT(?)维重建图像显示鼻腔鼻窦病变准确,可多方位多角度观察病变,立体感强,有助于临床医生治疗、手术计划的制订和实施##原图像不清晰
Objective To investigate the value of spiral CT three-dimensional reconstruction in the nasal cavity and nasal sinus. Methods 38 cases of maxillary sinus fracture, orbital bone, ethmoid sinus fracture in 6 cases, mandibular fracture in 4 cases, nasal bone fracture in 2 cases, frontal sinus fracture in 2 cases, chronic sinusitis and nasal polyps in 30 cases, nasal sinus tumors in 10 cases. All the cases of fracture were reconstructed by surface-covered display method. The rest cases were treated by air surface projection method to reconstruct the surface of the airway cavity, and simulated endoscopic imaging and multi-planar reconstruction . Three-dimensional reconstruction images were compared with the original coronal or axial images, as seen in the endoscopic and endoscopic findings. Results (1) 38 cases of maxillary sinus fracture surface reconstruction map with the original coronal or axial maps showed consistent with the surgical findings. (2) 30 cases of chronic sinusitis and nasal polyps and nasal sinus tumors in 10 cases, the air surface projection reconstruction images can clearly show the air chamber and airway stenosis and congestion, similar to air contrast, the size of the lesion showed by surgery See you. (3) The simulated endoscopic imaging was observed from the anteroposterior (foot) end of the approach, which clearly shows the structures and lesions in the nasal cavity, which are basically the same as described in the endoscopic and surgical procedures. (4) The images of multiplanar reconstruction are clear and the resolution is high. Compared with the original coronal or axial images, the normal anatomical structures such as the ostiomeatal and nasal complex, the location and morphology of the tumor and nasal polyps, and the relationship between the surrounding tissues are more clear. Conclusions Spiral CT (?) Dimensional reconstruction of the nasal cavity and paranasal sinuses shows that the lesions of the nasal cavity and paranasal sinuses are accurate, and the lesions can be observed in many directions and multi-angles. The stereoscopic feeling is strong, which is helpful to the clinicians in the treatment and operation planning. ## The original image is unclear