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目的探讨MSCT扫描斜轴位MPR在面神经管膝状窝及其周围骨折中的诊断价值。方法收集经行颅中窝面神经减压手术证实的面神经管膝状窝或鼓室段近端骨折患者33例,回顾分析其术前CT图像,将术中所见与常规轴位、冠状位及斜轴位MPR图像所见对比。比较2种诊断模式(常规轴位及冠状位联合应用,常规轴位、冠状位及斜轴位MPR联合应用)对面神经管膝状窝及其周围骨折的诊断符合率。结果术前CT显示骨折线累及膝状窝或鼓室段近端22例(66.67%),其中常规轴位显示8例(24.24%),冠状位显示6例(18.18%),斜轴位显示20例(60.61%)。常规轴位或冠状位及斜轴位图像均能显示骨折线累及膝状窝或鼓室段近端10例,仅斜轴位显示12例,常规轴位、冠状位或斜轴位均不能显示11例。斜轴位MPR显示面神经管膝状窝或鼓室段近端局限性扩大26例(78.79%)。统计分析表明2种不同的诊断模式对膝状窝及其周围骨折诊断符合率有统计学差别。结论斜轴位MPR与常规轴位、冠状位图像联合观察可提高术前面神经管膝状窝及其周围骨折的诊断符合率。
Objective To investigate the diagnostic value of MPR in oblique plane of MSCT in facial palsy and its surrounding fractures. Methods Totally 33 patients with facial nerve or knee tympanic canal proximal or proximal tympanic fractures confirmed by cranial fossa nerve decompression surgery were retrospectively analyzed. Their preoperative CT images were compared with those of conventional axial, coronal and oblique Axial MPR image comparison. The diagnostic coincidence rates of the two modes of diagnosis (conventional axial and coronal combined application, conventional axial, coronal and oblique MPR) were compared between the two groups. Results The preoperative CT showed that the fracture line involved the proximal part of the knee or tympanic segment in 22 cases (66.67%), of which 8 cases (24.24%) showed conventional axial position, 6 cases (18.18%) showed coronal position and 20 Cases (60.61%). Conventional axial or coronal and oblique axis images can show the fracture line involving the knee or proximal tympanic segment in 10 cases, only the oblique axis showed 12 cases, conventional axial, coronal or oblique axial position can not be displayed 11 example. Oblique axial MPR showed a limited extension of the proximal knee of the facial nerve canal or tympanic segment in 26 cases (78.79%). Statistical analysis showed that there were significant differences between the two diagnostic methods in the diagnosis of the knee and its surrounding fractures. Conclusions The combined observation of oblique axial MPR with conventional axial and coronal images can improve the diagnostic coincidence rate of the knee sulcus and its surrounding areas.