层螺旋CT对面神经管病变评价.docVIP

64层螺旋CT对面神经管病变的评价 作者：胡茂清 龙晚生 周红英 张朝桐 谭国强 李伟 兰勇 【摘要】 目的 探讨64层螺旋CT及图像后处理技术对面神经管病变的诊断价值。方法 回顾分析108例面神经管病变患者的CT资料，所有患者均行64层螺旋CT颞骨高分辨扫描，进行颞骨常规多平面重组，面神经管双斜位重组和曲面重组。 结果 面神经管骨折10例，其中鼓室段骨折8例，迷路段2例。中耳炎破坏面神经管67例，包括胆脂瘤型中耳炎60例，肉芽肿型中耳炎7例，外耳道胆脂瘤破坏面神经管9例，颞骨转移瘤破坏面神经管1例，颈静脉球增大致面神经管缺损2例。颞骨病变术后面神经管缺损19例，其中中耳癌术后1例，中耳胆脂瘤术后13例，外耳道胆脂瘤术后5例。 结论 64层螺旋CT颞骨高分辨扫描及图像后处理能清晰显示面神经管病变，对临床诊断和治疗有重要价值。 【关键词】 面神经管；颞骨；体层摄　影术，X线计算机 　　[Abstract] Objective To evaluate the diagnostic value of 64-slice spiral CT and its imaging post-processing technics in facial nerve canal disease. Methods CT data of 108 cases with the ficial nerve canal disease were analyzed retrospectively. High-resolution CT scanning was performed in all patients with 64-slice spiral CT and reconstruction of the facial nerve canal with imaging post-processing technics of regular multiplannar reconstruction(MPR), double oblique MPR and curved multiplanner reconstruction(CPR). Results Ten cases with fractures of the facial nerve canal, fracture involving the tympanic segment in 8 cases and the labyrinthine segment in 2 cases. Facial nerve canal bone destruction in cholesteatotampus tympanitis 60 cases(64 ears), granuloexsudative tympanitis 7 cases, external ear canal cholesyeatoma 9 cases, metastatic tumour of temporal bone 1 case, 2 cases facial nerve canal bone defect secondary to large jugular bulb. Facial nerve canal bone defect in 19 cases because of postoperation of temporal bone disease, which including middle ear cancer 1 case, cholesteatotampus tympanitis 13 cases, external ear canal cholesyeatoma 5 cases. Conclusion The disease of facial nerve canal can be demonstrated clearly by 64-slice spiral CT high-resolution scanning and its post-processing imaging, which contribute much to the clinical diagnosis and treatment. 　　[Key words] Facial nerve canal; Temporal bone; Computed tomography 　　面神经是人体内居骨管中最长的神经，也是最容易发生麻痹的神经，大多数面瘫是由于颞骨内病变累及面神经管后损伤面神经所致。CT图像上无法直接辨认面神经，但颞内段面神经可以借助面神经管来识别。应用多层螺旋CT图像后处理技术如多平面重组（MPR）、曲面重组（CPR）能够清晰显示面神经管的解剖结构，