15例成年国人颞骨内部结构CT解剖学

目的:研究成年国人颞骨内部解剖结构的CT重建图像,为临床耳显微外科及神经外科手术提供解剖学依据。方法:15名健康志愿者应用Picker5000螺旋CT机,平行于听眦线扫描,应用VoxelQ工作站进行多层面重建(multi planar reconstruction,MPR),表面遮盖重建(surface shaded display,SSD)及仿真内窥镜成像(CT virtual endoscopy,CTVE),多角度旋转观察颞骨内部解剖结构。结果:MPR能在不同切面显示耳蜗、半规管、内耳道及面神经管垂直段等结构,显示率为100%;SSD能清晰显示颞骨重要的骨性结构,如内耳门、颈静脉孔等,冠状位切割后的SSD图像能生动地显示锤骨、砧骨的立体形态及空间关系;CTVE可模仿内窥镜从外耳向中耳移动,清晰显示骨性外耳道、鼓室内侧壁及听骨链等结构。结论:MPR可行多方位重建,有助于耳颞部病变的全面了解,是轴位CT良好的补充;SSD、CTVE可准确、立体的观察颞骨内部解剖结构,对临床诊断、手术方案的设计、医学教学等具有指导意义。

Anatomic study of intratemporal structures of 15 adult Chinese on spiral CT

Objective: To study reconstructed CT images of intratemporal structures of adult Chinese and provide anatomic basis for otochirurgia and neurosurgery. Methods: Inner ears of 15 volunteers were scanned with a Picker 5000 Spiral CT scanner. All original images were transferred into Voxel Q workstation and reconstructed, rotated from various angles and observed by using multi planar reconstruction, surface shaded display reconstruction and CT virtual endoscopy reconstruction. Results:The satisfactory MPR images of cochlea, bony semicircular canals, internal auditory meatus and other intratemporal structures can be obtained. The SSD images could show some important bony marks of temporal bone and spatial relationships between them clearly. On coronal plane, SSD images can vividly demonstrate the shape and spatial relationships of malleus and incus. A series images were obtained as the virtual endoscope moved from the external auditory canal to the middle ear cavity. Virtual endoscopy could well demonstrate the surface of medial wall and ossicles. Conclusions:The images of spiral CT including SSD, MPR and CTVE will enrich diagnostic information for observers. The reconstructed images are reliable for clinic diagnosis and medical education.