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目的:为临床安全、有效地行经鼻内镜视神经减压术提供更加充分的影像学支持。方法:应用多层螺旋CT(MSCT)和AW4.1影像工作站对14例(14侧)外伤性视神经病患者蝶、筛窦外侧壁的视神经管和颈内动脉进行三维重建、空间立体定位和相关数据测量,并与术中视神经实际走行情况进行比较验证。结果:①鼻骨尖-前床突扫描基线与视神经管走行一致;②视神经管内侧壁长度为(11.83±2.31)mm;③CT影像学的视神经管定位标记线和增强的颈内动脉可以同时并全程显示在矢状位三维重建的蝶、筛窦外侧壁上,而且与术中实际情况基本一致。结论:鼻骨尖-前床突线是研究视神经管的最佳扫描基线;采用MSCT和AW4.1工作站能对视神经管进行术前空间立体定位,可简单、直观、准确地反映每例患者视神经管的长度,与蝶、筛窦外侧壁的毗邻关系和空间走行情况以及与颈内动脉的关系,其临床价值明显优于传统的CT,为术者制定合理的手术方案,进行安全、有效的经鼻内镜视神经减压术提供了更加充分和实用的影像学支持。
Objective: To provide more adequate imaging support for the safe and effective operation of endoscopic optic nerve decompression. Methods: Three-dimensional reconstruction of the optic canal and internal carotid artery in the lateral and lateral ethmoid sinus of 14 patients (14 sides) with traumatic optic neuropathy was performed with MSCT and AW4.1 imaging workstation. Data were measured and compared with the actual situation of optic nerve during operation. Results: ① The baseline of nasal tip-anterior-bed scan was consistent with the optic canal. The length of the lateral wall of the optic canal was (11.83 ± 2.31) mm. ③ The CT image of the optic canal marker line and the enhanced internal carotid artery could be simultaneously and completely Showed in the sagittal three-dimensional reconstruction of the butterfly, ethmoid sinus wall, and the actual situation is basically the same surgery. Conclusion: The nasal tip - anterior bed protrusion is the best scan baseline for the study of the optic canal. MSCT and AW4.1 workstation can be used to stereotactic the optic canal of the optic canal preoperatively, which can be easily, directly and accurately reflect the optic canal of every patient Length, and the butterflies, ethmoid lateral wall of the adjacent relationship and spatial walking conditions and the relationship with the internal carotid artery, its clinical value was significantly better than the traditional CT, for the surgeon to develop a reasonable surgical plan for safe and effective by the Endoscopic decompression of the optic nerve provides more adequate and practical imaging support.