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《經(jīng)鼻蝶竇手術(shù)路徑的體表定位及鼻蝶竇區(qū)的三維CT影像解剖》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在行業(yè)資料-天天文庫(kù)。
1、經(jīng)鼻-蝶竇手術(shù)路徑的體表定位及鼻-蝶竇區(qū)的三維CT影像解剖馬躍輝肖圣祥潘德生溫良俞建波周永慶詹仁雅[摘要]目的探討三維螺旋CT在鼻-蝶鞍區(qū)影像解剖及經(jīng)鼻-蝶竇垂體瘤手術(shù)入路的鞍底定位中的應(yīng)用。方法回顧性分析29例鼻-蝶鞍區(qū)螺旋CT掃描數(shù)據(jù)，以3D重建和剪切技術(shù)重建和觀察鼻-蝶鞍區(qū)的3D解剖結(jié)構(gòu)。分析鼻尖-耳輪上緣連線（鼻-耳輪線）與鞍底的關(guān)系。對(duì)14例垂體瘤患者術(shù)前、術(shù)后行螺旋CT掃描和重建，評(píng)估3D-CT和鼻-耳輪線在經(jīng)鼻-蝶竇垂體瘤術(shù)前規(guī)劃和術(shù)中鞍底定位中的可行性。結(jié)果鼻-耳輪線在所有的研究對(duì)象中均與蝶竇相交，其中與鞍底相交者12例占42％。鞍底-斜坡交點(diǎn)至鼻-耳
2、輪線的垂直距離是(3.6±1.8)mm。3D-CT能清晰地顯示鼻-蝶鞍區(qū)的解剖結(jié)構(gòu)，包括蝶竇及其分隔、頸動(dòng)脈和視神經(jīng)管隆起、鞍底等。為模擬手術(shù)入路和術(shù)中鞍底定位提供重要信息。結(jié)論3D-CT技術(shù)可獲得鼻-蝶鞍區(qū)高清晰度的三維空間解剖圖像，有助于經(jīng)鼻-蝶竇垂體瘤手術(shù)方案的制定和術(shù)中蝶竇和鞍底的定位。鼻-耳輪線可作為經(jīng)鼻-蝶竇垂體瘤手術(shù)路徑的體表定位。垂體腺瘤；經(jīng)蝶入路；螺旋CT三維重建Orientationofendonasaltranssphenoidalsurgicaltrajectoryandsellaturcicaanatomybythreedimensional
3、computedtomographyMAYue-huiXIAOSheng-xiangPANDe-shengWENLiangYUJian-boZHOUYong-qingZHANRen-yaDepartmentofNeurosurgery,TheFirstAffiliatedHospital,CollegeofMedicine,ZhejiangUniversity,Hangzhou310003,China[Abstract]ObjectiveTostudytheanatomyandoritentionofnose,sellaturcicainendonasaltranss
4、phenoidalapproachbythreedismensioncomputertomography(3D-CT).MethodsCTdataofnoseandsellaturcicain29caseswasstudiedonretrospectively.The3Dconfigurationofnoseandsellaturcicawereconstructedandobservedusingimagereconstructionwithsurgicalclipimageregistration.Therelationbetweensellarfloorandt
5、helinefromnosetiptoapexoftheearhelix(nosetipearapexline)wasanalyzed.Thepracticabilityofnosetip-earapexlineand3D-CTtoorientthesellarfloorinendonasaltranssphenoidalapproachwasevaluatedin14patientswithpituitaryadenoma.ResultsNosetip-earapexlinepassedthroughthesphenoidsinusin100％ofthecasesa
6、ndthroughthesellarfloorin42％ofthecases.Themeandistancefromthesellarfloor-clivuspointperpendicularlytothenosetip-earapexlinewas(3.6±1.8)mm.The3D-CTimagingclearlyandindividuallydisplayedtheconfigurationofnoseandsellaturcicainsequentiallayersincludingsphenoidsinus,itsboneseptum,opticprotub
7、erance,carotidprotuberanceandsellarfloor,thuscansimulatetranssphenoidalsurgeryandhelptofindsellarfloor.ConclusionThe3D-CTimagingprovidesabesttoolforvisualizingthepatient'sanatomypreoperativelyandmoreintuitivelydisplayingthenoseandsellaturcicaandhelpstofindsellarfloor.Thenosetip
