【摘要】：目的：運用CT多平面重組(MPR)技術顯示無顳骨解剖結構異常患者的巖淺大神經(jīng)管(greater superficial petrosal nerve canal,GSPNC)及其周圍解剖結構,測量與顱中窩入路手術相關的解剖結構間的正常值范圍,探討顳骨CT對顱中窩入路手術的術前應用價值。 方法：搜集自2011年8月—12月期間于我所采用SIEMENS sensation cardiac16或64CT機行顳骨高分辨率CT掃描的無顳骨發(fā)育畸形、顳骨外傷史和顳骨手術史的患者,掃描參數(shù)為：120kV300mAs(兒童120kV84mAs),準直器寬度0.6mm,螺距0.75,矩陣512×512,視野(FOV)250×250mm.所得圖像在工作站行MPR后處理,分別顯示巖淺大神經(jīng)管全程、棘孔、耳蝸、頸動脈管膝部及上半規(guī)管,探討與顱中窩入路手術密切相關的各解剖結構之間的相對位置關系并測量其徑線值。 結果：測得棘孔至巖淺大神經(jīng)裂孔的距離為10.3±2.2mm(5.5～15.1mm),巖淺大神經(jīng)管的長度為2.8±2.4mm(0～15.7mm),膝狀神經(jīng)窩表面骨質厚度為2.0±1.7mm(0～7.4mm),棘孔至耳蝸的距離為10.6±1.9mm(6.9～15.7mm),棘孔至膝狀神經(jīng)節(jié)的距離為12.4±2.1mm(7.3～17.3mm),耳蝸至頸動脈管膝部最短距離為1.9±0.9mm(0.5～5.3mm),上半規(guī)管表面的骨質厚度為1.2±0.7mm(0-3.8mm)等；GF表面骨質厚度所測數(shù)值左右兩側間有統(tǒng)計學差異p=0.015),余各徑線值左右兩側無明顯統(tǒng)計學差異(p0.05)；各組徑線值的變異系數(shù)中,GSPNC的長度和膝狀神經(jīng)窩表面骨質厚度變異系數(shù)最大(≥85%)。 結論：顳骨高分辨率CT圖像可以清楚顯示顳骨內(nèi)部各骨性解剖結構,MPR后處理技術的應用能夠顯示各解剖結構間的相對位置關系。對需顱中窩入路行顳骨手術的患者,術前顳骨高分辨率CT檢查有助于確定更準確的個性化手術方案。
[Abstract]:Objective: To study the normal range of the anatomical structure related to the operation of the fossa in the cranial fossa by using the CT multi-plane recombination (MPR) technique to display the large-scale neural tube (GSPNC) and the surrounding anatomical structure of the abnormal patient with the abnormal anatomical structure of the skull. To evaluate the preoperative value of CT in the operation of the fossa in the cranial fossa. Methods: The scan parameters were 120kV300mAs (the children 120kV84mAs), the collimator width of 0.06mm and the pitch of 0.7. 5. Matrix 512-512, field of view (FOV) 250-250m m. the obtained images are post-processed at the workstation row MPR to respectively display the relative positional relationship between the various anatomical structures which are closely related to the operation of the fossa in the cranial fossa and measure the radial lines of the whole course, the spine hole, the cochlea, the carotid artery knee and the upper half gauge tube of the rock shallow large nerve tube, The results showed that the distance between the spinous process and the deep hole of the rock was 10. 3-2. 2 mm (5. 5-15. 1 mm), the length of the shallow and large nerve tube was 2.8-2.4mm (0-15. 7mm), the thickness of the surface of the knee-like nerve was 2.0-1.7mm (0-7. 4 mm), the distance between the spinous process and the cochlea was 10. 6-1. 9mm (6. 9-15. 7 mm), and the distance between the spinous process and the knee-like ganglion was 12. 4-2.1mm (70.3-17. 3). The minimum distance between the cochlea and the carotid artery was 1. 9-0. 9mm (0.5-5.3mm), and the bone thickness of the upper half-gauge tube was 1. 2-0. 7mm (0-3. 8mm). There was a statistical difference between the left and right sides of the surface of the GF (p = 0.015), and there was no significant difference between the left and right sides of each radial line (p0. 05), the coefficient of variation of each group of radial line values, the length of the GSPNC and the coefficient of variation of the bone thickness on the surface of the knee-like nerve socket (Table 8) Conclusion: The high-resolution CT image of high-resolution bone can clearly show the anatomic structure of the bone in the bone, and the application of the post-treatment technique of MPR can show the phase between the anatomical structures. A positional relationship. A high-resolution CT examination of a pre-operative, pre-operative, high-resolution, high-resolution CT scan helps to determine a more accurate personality for patients in need of a bone-in-the-cranial fossa approach.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R816.1

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