泪囊造影CT在创伤性泪道损伤中的作用

发布时间：2018-08-01 09:36

【摘要】：目的:探讨泪囊造影CT在创伤性泪道损伤中的诊断价值,为鼻内镜下泪囊鼻腔吻合术提供指导。方法:对28例创伤性泪道损伤患者行泪囊造影薄层CT扫描,在同步工作站进行容积成像、最大密度投影、曲面重建、三维重建等以显示泪囊的形态、泪囊窝骨折移位情况及泪道阻塞部位,并观察钩突与泪囊窝的关系,测量泪囊窝前上部上颌骨额突与后下部泪骨的厚度,中鼻甲腋分别至泪囊顶、泪囊底之间的距离。结果:泪囊造影CT能显示泪囊的形态、泪囊窝骨折移位情况、泪道阻塞部位以及钩突与泪囊窝的关系,发现泪小管堵塞6例,泪囊阻塞14例,鼻泪管阻塞8例;泪囊窝前上部及后下部骨质的平均厚度分别为(2.96±0.30)mm和(0.02±0.005)mm,中鼻甲腋至泪囊顶、泪囊底之间的距离分别为(6.80±1.50)mm、(4.00±1.80)mm(P0.05)。结论:泪囊造影CT结合容积成像、最大密度投影、曲面重建、三维重建等均能清晰显示泪囊形态、泪囊窝骨折移位情况及泪道阻塞部位,分析钩突与泪囊窝的关系,为鼻内镜下泪囊鼻腔吻合术提供临床指导。
[Abstract]:Objective: to evaluate the diagnostic value of dacryocystor-CT in traumatic lacrimal duct injury and to provide guidance for dacryocystorhinostomy under nasal endoscope. Methods: a total of 28 patients with traumatic lacrimal duct injury underwent thin slice CT scanning of dacryocystigraphy. Volume imaging, maximum density projection, curved surface reconstruction and 3D reconstruction were performed on the synchronous workstation to show the shape of the lacrimal sac. The relationship between the uncinate process and the lacrimal sac fossa was observed. The thickness of the frontal process of the upper maxillary bone and the posterior lower part of the lacrimal bone and the distance between the middle turbinate axil to the dacryocyst roof and the lacrimal sac floor were measured. Results: the morphology of lacrimal sac, the fracture and displacement of lacrimal sac fossa, the location of lacrimal duct obstruction and the relationship between uncinate process and lacrimal sac fossa were revealed by dacryocystor-enhanced CT. The results showed that lacrimal canaliculus was blocked in 6 cases, lacrimal sac in 14 cases and nasolacrimal duct obstruction in 8 cases. The average thickness of the upper and lower parts of the lacrimal sac was (2.96 卤0.30) mm and (0.02 卤0.005) mm, respectively. The distance between the middle turbinate axil and the dacryocyst roof was (6.80 卤1.50) mm, () 4.00 卤1.80) mm (P0.05). Conclusion: Ct combined with volumetric imaging, maximum density projection, curved surface reconstruction and 3D reconstruction can clearly display the shape of lacrimal sac, fracture displacement of lacrimal sac fossa and the location of lacrimal duct obstruction, and analyze the relationship between uncinate process and lacrimal sac fossa. To provide clinical guidance for dacryocystorhinostomy under nasal endoscope.
【作者单位】：南方医科大学珠江医院耳鼻咽喉头颈外科;佛山市中医院耳鼻咽喉科;佛山市中医院CT室;
【分类号】：R779.1

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