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钩突的影像解剖学研究 |
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郎军添 廖建春 王海青 李雪宏
【摘 要】 目的：研究钩突的影像解剖及其与鼻窦炎的关系。方法：对67例头颅冠状CT薄层扫描片(其中鼻窦炎组40例80侧，非鼻窦炎组27例54侧)上钩突的影像解剖形态进行了观测，内容包括：钩突附着类型、高度、厚度和角度，并对测量结果与鼻窦炎积分进行了相关性分析。结果：钩突头端的附着部位有3种类型：筛顶型(37.0%)、纸样板型(35.2%)和中鼻甲型(27.8%)，这3种类型的比例在鼻窦炎组与非鼻窦炎组有显著差异。鼻窦炎组钩突高度及钩突角度与鼻窦炎积分之间有显著相关性(前者呈正相关，后者呈负相关)。结论：筛漏斗及钩突的发育等解剖因素与慢性鼻窦炎发病有密切关系。
【关键词】 钩突 影像解剖 冠状CT 慢性鼻窦炎
Imageing anatomy studg of the uncinate process
Lang Juntian,Liao Jianehun,Wang Haiqing,et al.
Department of Otorhinilaryngology,Changzheng Hospital of the Second Military Medical University,Shanghai 200003
Objective:To study the relationship between the imaging anatomy of the uncinate process and the chronic sinusitis.Methods:The attachment of the superior part of the uncinate process,the highness,thickness and the angle of uncinate process were observed and measured on 67 coronal CT slices (40 chronic sinusitis patients and 27 normal people).The relationship between the image anatomy and the sinusitis was also studied.Results:The superior part of the uncinate process may attach to three different structures such as the skull base,the papyraceous lamina and the middle turbinate.The incidence of the three attachment was significant different between the sinusitis patients and normal adults.The highness and angle of uncinate process were correlated to the score of the sinus opacity of sinusitis patients,positively and negatively respectively.Conclusion:The anatomy structure of the uncinate process plays a great role in the initiation and development of chronic sinusitis.
Key words Uncinate process Coronal CT Anatomy Chronic sinusitis
目前，鼻窦包括钩突的解剖、病理生理学的研究开展较为广泛且深入，但是影像学方面的研究尚处于大体的直观描述范围，影像解剖研究更是少见［1］。我们在对钩突的解剖进行过大量观测的基础上［2］，通过头颅冠状CT薄层扫描片的观测，重点研究了钩突的影像解剖学，以期为临床慢性鼻窦炎的诊断及手术治疗提供形态学基础。
1 材料与方法
1.1 材料
1996年4月至1997年9月，在我院行头颅冠状位CT扫描的患者67例(由于鼻、鼻窦占位，有鼻手术史，颌面畸形，以及拍摄显像不清等原因影响观测者除外)。分为2组：①鼻窦炎组(指有鼻塞、流涕、头痛、失嗅等临床表现，经CT扫描证实鼻窦有炎症存在而确诊[1] [2] 下一页
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