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目的探讨多层螺旋CT对面神经管垂直部(vertical facical nerve,VFN)毗邻解剖关系的显示与测量的价值及其临床意义。资料与方法(1)标本研究:采用64层螺旋CT对4具干颅标本进行扫描,在横断位分别测量VFN至外耳道后壁、外耳门后缘、乙状窦沟前壁、颈静脉窝的水平距离,以及外耳道后壁至乙状窦沟前壁之间水平距离;按影像层面锯开标本对上述距离行实体测量。影像测量均值与实体测量均值差异行显著性检验。(2)在体研究:随机入选无耳部疾患自愿者118人(236侧),其中女63人(126侧),男55人(110侧);行颌面部CT扫描。测量指标同标本研究。结果(1)标本研究:各项指标的影像测量值与实体测量值差异无统计学意义(P>0.05)。(2)在体研究:VFN距颈静脉窝之间水平距离侧别差异有统计学意义(P<0.05),性别之间差异无统计学意义(P>0.05),其余各项指标测量结果侧别差异无统计学意义(P>0.05),性别差异有统计学意义(P<0.05)。结论多层螺旋CT能较好显示VFN及其周围结构的解剖位置和毗邻关系,可为耳科、面神经疾病及部分神经外科手术术式选择和避免术中意外提供可靠信息。
Objective To investigate the value and clinical significance of multi-slice spiral CT in the display and measurement of the adjacent anatomical relationship of the facial nerve root canal (VFN). Materials and Methods (1) Specimen Study: Four 64-slice spiral CT scans of the cranial cranium were performed. The VFN was measured transversely to the posterior wall of the external auditory canal, the posterior margin of the external auditory meatus, the anterior wall of the sigmoid sinus, the jugular fossa Horizontal distance, and the horizontal distance between the posterior wall of the external auditory canal and the anterior wall of the sigmoid sinus. The specimens were sawn according to the image level and measured physically. Significant test was made on the difference between the means of image measurement and the mean value of physical measurement. (2) In-vivo study: A total of 118 volunteers (236 sides) with no ear disease were enrolled. Among them, 63 were women (126 sides) and 55 were men (110 sides). The maxillofacial CT scan was performed. Measurement index with specimen research. Results (1) Specimen study: there was no significant difference between the measured and the measured values of each index (P> 0.05). (2) In vivo study: There was significant difference in the horizontal distance between VFN and jugular fossa (P <0.05), but there was no significant difference between gender (P> 0.05) No difference was statistically significant (P> 0.05), the gender difference was statistically significant (P <0.05). Conclusions Multi-slice spiral CT can better display the anatomical location and adjacent relationship of VFN and its surrounding structures, and provide reliable information for the selection and avoidance of intraoperative accidents in otology, facial nerve diseases and partial neurosurgery.