發(fā)布時(shí)間：2019-02-21 15:20

【摘要】：目的：運(yùn)用CT多平面重組(MPR)技術(shù)顯示無(wú)顳骨解剖結(jié)構(gòu)異�；颊叩膸r淺大神經(jīng)管(greater superficial petrosal nerve canal,GSPNC)及其周圍解剖結(jié)構(gòu),測(cè)量與顱中窩入路手術(shù)相關(guān)的解剖結(jié)構(gòu)間的正常值范圍,探討顳骨CT對(duì)顱中窩入路手術(shù)的術(shù)前應(yīng)用價(jià)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(jī)行顳骨高分辨率CT掃描的無(wú)顳骨發(fā)育畸形、顳骨外傷史和顳骨手術(shù)史的患者,掃描參數(shù)為：120kV300mAs(兒童120kV84mAs),準(zhǔn)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(dòng)脈管膝部及上半規(guī)管,探討與顱中窩入路手術(shù)密切相關(guān)的各解剖結(jié)構(gòu)之間的相對(duì)位置關(guān)系并測(cè)量其徑線值。 結(jié)果：測(cè)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(zhǎng)度為2.8±2.4mm(0～15.7mm),膝狀神經(jīng)窩表面骨質(zhì)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(dòng)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(zhì)厚度為1.2±0.7mm(0-3.8mm)等；GF表面骨質(zhì)厚度所測(cè)數(shù)值左右兩側(cè)間有統(tǒng)計(jì)學(xué)差異p=0.015),余各徑線值左右兩側(cè)無(wú)明顯統(tǒng)計(jì)學(xué)差異(p0.05)；各組徑線值的變異系數(shù)中,GSPNC的長(zhǎng)度和膝狀神經(jīng)窩表面骨質(zhì)厚度變異系數(shù)最大(≥85%)。 結(jié)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(jié)構(gòu),MPR后處理技術(shù)的應(yīng)用能夠顯示各解剖結(jié)構(gòu)間的相對(duì)位置關(guān)系。對(duì)需顱中窩入路行顳骨手術(shù)的患者,術(shù)前顳骨高分辨率CT檢查有助于確定更準(zhǔn)確的個(gè)性化手術(shù)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(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R816.1

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