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目的研究颅面部骨性管道的多层螺旋CT曲面重建成像。方法用PhilipsMx80004层螺旋CT,对267例病人的颅面部骨性管道行曲面重建。其中面神经管217例,视神经管28例,颈动脉管7例,颈静脉孔4例,舌下神经管2例,下颌管9例。扫描参数:120kV,200~250mAs,准直0.5mm,螺距0.875,扫描时间0.75s/周,矩阵512×512。除面神经管扫描的准直为0.5mm,重建间隔为0.2mm外,其余各部位的准直为0.5~1.0mm,重建间隔0.2~0.5mm。重建矩阵均为1024×1024。结果267例中除11例因扫描时受检者头部轻微晃动,部分曲面重建图像显示欠清晰外,其余256例均获得清晰的曲面重建图像。217例面神经管曲面重建中,面神经管未见异常178例。先天性外耳、中耳或内耳畸形伴有面神经管的位置、走行、长度异常18例。慢性中耳乳突炎合并胆脂瘤并累及面神经管8例。岩骨骨折伴外伤性面瘫21例中,发现面神经管骨壁断离或有碎片9例。面神经瘤或面神经管附近肿瘤致面神经管壁破坏4例。视神经管正常24例,视神经管骨折3例,骨纤维异常增殖症累及视神经管导致狭窄1例。颈动脉管正常4例,颈动脉管骨折2例,岩尖胆脂瘤致使颈动脉管破坏1例。颈静脉孔正常2例,颈静脉孔神经鞘瘤2例。舌下神经管正常1例,舌下神经鞘瘤1例。下颌管正常4例,下颌骨骨髓炎及下颌骨骨折各2例,下颌骨肿瘤1例,均有下颌管受累。结论颅面部骨性管道的多层螺旋CT曲面重建,可清晰、直观地显示其全貌,是轴面及多平面重建图像的重要补充。
Objective To study the multi-slice helical CT surface reconstruction of craniofacial bony duct. Methods The craniofacial bony canal of 267 patients was reconstructed with PhilipsMx80004 slice spiral CT. There were 217 cases of facial nerve canal, 28 cases of optic canal, 7 cases of carotid artery, 4 cases of jugular foramen, 2 cases of sublingual nerve canal and 9 cases of mandibular canal. Scanning parameters: 120kV, 200 ~ 250mAs, collimation 0.5mm, pitch 0.875, scan time 0.75s / week, matrix 512 × 512. In addition to facial nerve tube scan collimation 0.5mm, reconstruction interval of 0.2mm, the remaining parts of the alignment 0.5 ~ 1.0mm, reconstruction interval 0.2 ~ 0.5mm. The reconstruction matrix is 1024 × 1024. Results Of the 267 cases, 11 of the 267 patients were slightly swayed by the head of the patient and some of the images of the surface reconstruction were not clear. The other 256 patients received clear surface reconstruction images. There were 178 cases of facial nerve canal abnormalities in 217 cases of facial nerve surface reconstruction. Congenital external ear, middle ear or inner ear deformity associated with facial nerve tube position, walking, length abnormalities in 18 cases. Chronic otitis media with cholesteatoma and involving facial nerve canal in 8 cases. In 21 cases of petrous bone fracture with traumatic facial paralysis, 9 cases were found with broken or broken facial nerve wall. 4 cases of facial nerve wall damage caused by facial neuroma or facial nerve tube. 24 cases of optic canal normal, 3 cases of optic canal fracture, bone fibrous dysplasia involving the optic canal leads to stenosis in 1 case. Carotid artery in 4 cases of normal, two cases of carotid artery fracture, petrous apexification of the carotid artery in 1 case. 2 cases of normal jugular foramen, 2 cases of jugular vein schwannoma. 1 case of normal sublingual nerve canal, 1 case of hypoglossal schwannoma. The mandibular canal was normal in 4 cases, mandibular osteomyelitis and mandibular fracture in 2 cases, mandibular tumor in 1 case, both mandibular tuberculosis involvement. Conclusion The multi-slice helical CT reconstruction of craniofacial bony canal can show the whole picture clearly and intuitively, which is an important complement to axial and multiplanar reconstruction images.