岩浅大神经管及其周围解剖结构的CT显示与测量

发布时间：2019-02-21 15:20

【摘要】：目的：运用CT多平面重组(MPR)技术显示无颞骨解剖结构异常患者的岩浅大神经管(greater superficial petrosal nerve canal,GSPNC)及其周围解剖结构,测量与颅中窝入路手术相关的解剖结构间的正常值范围,探讨颞骨CT对颅中窝入路手术的术前应用价值。方法：搜集自2011年8月—12月期间于我所采用SIEMENS sensation cardiac16或64CT机行颞骨高分辨率CT扫描的无颞骨发育畸形、颞骨外伤史和颞骨手术史的患者,扫描参数为：120kV300mAs(儿童120kV84mAs),准直器宽度0.6mm,螺距0.75,矩阵512×512,视野(FOV)250×250mm.所得图像在工作站行MPR后处理,分别显示岩浅大神经管全程、棘孔、耳蜗、颈动脉管膝部及上半规管,探讨与颅中窝入路手术密切相关的各解剖结构之间的相对位置关系并测量其径线值。结果：测得棘孔至岩浅大神经裂孔的距离为10.3±2.2mm(5.5～15.1mm),岩浅大神经管的长度为2.8±2.4mm(0～15.7mm),膝状神经窝表面骨质厚度为2.0±1.7mm(0～7.4mm),棘孔至耳蜗的距离为10.6±1.9mm(6.9～15.7mm),棘孔至膝状神经节的距离为12.4±2.1mm(7.3～17.3mm),耳蜗至颈动脉管膝部最短距离为1.9±0.9mm(0.5～5.3mm),上半规管表面的骨质厚度为1.2±0.7mm(0-3.8mm)等；GF表面骨质厚度所测数值左右两侧间有统计学差异p=0.015),余各径线值左右两侧无明显统计学差异(p0.05)；各组径线值的变异系数中,GSPNC的长度和膝状神经窝表面骨质厚度变异系数最大(≥85%)。结论：颞骨高分辨率CT图像可以清楚显示颞骨内部各骨性解剖结构,MPR后处理技术的应用能够显示各解剖结构间的相对位置关系。对需颅中窝入路行颞骨手术的患者,术前颞骨高分辨率CT检查有助于确定更准确的个性化手术方案。
[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.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R816.1

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