功能性内窥镜鼻窦手术前筛动脉血管 CT成像分析

目的：利用256排CT进行筛前、筛后动脉血管成像，为功能性内窥镜鼻窦手术（ functional endoscopic sinus surger-y， FESS）提供术前参考。方法对40例鼻炎和/或鼻窦炎患者进行256排CT头部血管成像，在工作站进行二维和三维重建分析，辨别筛前动脉和筛后动脉，统计其出处（眼动脉O1-O3段），测量筛前动脉与前鼻棘距离及其连线与鼻底的夹角。结果辨别出40例患者筛前动脉75支，辨别出24例患者筛后动脉39支；其中，有70支筛前动脉起自眼动脉O3段，占93．3％，5支起自眼动脉弯，占6．7％。有22支筛后动脉起自眼动脉弯，占56．4％，10支筛后动脉起自O2段，占25．6％，7支筛后动脉起自O3段，占17.9％；表现为同一患者双侧不一定对称；测量筛前动脉与前鼻棘距离（85．1±3．1） mm，与鼻底夹角为（49．3±0.8）°。结论用256排CT进行筛前、筛后动脉血管成像，辨识率较高，相关数据测量有助于术前了解筛动脉情况，有利于预防FESS大出血。

CTA scan of arteria ethmoidalis before functional endoscopic sinus surgery

Objective To make CTA scan of arteria ethmoidalis by 256-ranked spiral CT before FESS , so as to provide evi-dence for surgery.Methods CTA scan of arteria ethmoidalis was made in 40 cases, then, 2-dimentional and 3-dimentional analyses were performed at the work station to distinguish anterior ethmoidal artery from posterior ethmoidal artery , and statistics was then made to ana-lyze their starting points （ O1-O3 segments of ophthalmic artery ） .Then, the distance between anterior ethmoidal artery and anterior nasal spina, and also the angle between the connect line and the nasal base were measured respectively .Results All the 40 cases displayed an-terior ethmoidal artery （75 vessels）, 24 cases displayed posterior ethmoidal artery （39 vessels）.Seventy anterior ethmoidal arteries star-ted from O3 segment of the ophthalmic artery , accounting for 93.3%, 5 anterior ethmoidal arteries started from ophthalmic artery arch , ac-counting for 6.7%.Twenty-two posterior ethmoidal arteries started from ophthalmic artery arch , accounting for 56.4%.Ten posterior eth-moidal arteries started from O 2 segment of the posterior ophthalmic artery , accounting for 25.6%.Seven posterior ethmoidal arteries star-ted from O3 segment, accounting for 17.9%.Asymmetry could be noted bilaterally in the same patient .The measured distance between the anterior ethmoidal artery and anterior nasal spina was （85.1 ±3.1）mm, and the angle between the connect line and the nasal base was 49.3 ±0.8°.Conclusion Imaging of artery ethmoidalis by the 256-ranked Spiral CT was of high resolution , and related data obtained fa-cilitated a better knowledge of artery ethmoidalis before surgery , and was helpful to the prevention of hematorrhea in FESS .