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目的:利用多排CT扫描后可行上、下颌骨全景曲面重建的特点,探讨多排CT曲面全景片对颌骨疾病的诊断价值及指导临床手术的应用价值。方法:自2002.3.以来,对29例上、下颌骨疾病(包括上、下颌骨囊肿22例、颌骨骨髓炎2例、牙龈癌5例)行16排螺旋CT扫描,扫描层厚0.625mm或1.25mm,将扫描数据传至工作站(GE公司advantageworkstation,AW4.0),对上、下颌骨行不同层面的曲面断层重建,贮存图像并对图像进行分析。同时用X光机拍摄口腔全景片,将二种全景片进行阅片对比。结果:多排CT曲面断层全景片清晰,能清楚显示骨质的细微变化、骨病变的范围及其与周围组织及器官(如牙齿、上颌窦、下齿槽神经管)的关系,无颊舌侧骨组织覆盖影,其图像对疾病的定性诊断具有明确的指导价值,而X线口腔全景片有影像失真,在病变处存在颊舌侧骨质相互重叠影。结论:多排CT口腔全景断层片能非常清晰地显示骨病变与周围组织及牙齿的关系,可显示骨质的细微变化,无放大失真,对颌骨病变的定性诊断、病变范围的界定结果可靠。对临床医师在疾病的诊断,术前手术方案的制订有重要的指导价值。
Objective: To explore the diagnostic value of multi-slice CT panoramic panoramic film for the diagnosis of jaw diseases and the value of clinical operation guided by multi-slice computed tomography (CT) scan. METHODS: Twenty-nine patients with upper and mandibular diseases (including 22 cases of maxillary and mandibular cysts, 2 cases of osteomyelitis osteomyelitis and 5 cases of gingival carcinoma) were examined by 16-slice spiral CT scan since 2002.3. 1.25mm, the scanned data was transmitted to the workstation (GE company advantageworkstation, AW4.0), the upper and mandibular reconstruction of different levels of surface tomography, image storage and image analysis. At the same time with the X-ray filming oral panoramic film, the two panoramic films for reading comparison. Results: The multi-slice panoramic CT surface panoramic slice clearly showed the slight changes of bone, the range of bone lesions and its relationship with the surrounding tissues and organs (such as teeth, maxillary sinus and inferior alveolar nerve canal) The image of the bone has a clear guiding value for the qualitative diagnosis of the disease, while the X-ray panoramic film has the image distortion, and there is the overlapping shadow of the buccal and lingual bone in the lesion. Conclusion: Multi-slice CT panoramic tomography can show the relationship between bone lesions and the surrounding tissues and teeth very clearly. It can show the subtle changes of bone mass without magnification distortion. It can qualitatively diagnose jaw lesions and define the range of lesions . For clinicians in the diagnosis of disease, preoperative surgical program has important guiding value.