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目的通过观察正常额隐窝区域的 CT 影像学特征,加深对额隐窝区域部分重要解剖标志的认识。方法选择49例(98侧)无额窦疾病症状且额隐窝区域无病变表现的患者,对头部行16排螺旋 CT 扫描(螺距0.562,扫描层厚0.625mm,层距0.3mm),然后在图像工作站上进行冠状位、矢状位和水平位图像重建(层厚0.625mm,窗宽+2000HU,窗位+200HU)。观察 CT 影像上鼻丘气房、钩突上端附着点、终末隐窝、额气房、筛泡上气房、额泡气房和额窦内间隔气房等解剖标志的出现比率。结果鼻丘气房的出现率为94%(92/98)。钩突前上部参与构成鼻丘气房的内壁、上壁、下壁和后壁,后上部向上可有单一附着点(65%,64/98)或两个附着点(35%,34/98)。钩突后上端的单一附着点主要位于眶纸板(53%,52/98),也可附着于中鼻甲(9%)或颅底(3%)。钩突后上部的两个附着点主要附着于眶纸板和颅底(24%),也可附着于眶纸板和中鼻甲(10%),仅1侧(1%)附着于颅底和中鼻甲。87%(85/98)的钩突后上端在眶纸板上有附着点,与眶纸板接合部的下方形成终末隐窝。额气房的出现率为33%(32/98),其中Ⅰ型最多见(23%)、Ⅱ型(2%)和Ⅲ型(7%)少见,未见Ⅳ型额气房。筛泡上气房、额泡气房和额窦间隔气房的出现率分别为31%、7%和14%。结论多排螺旋 CT 实现了单次扫描、多平面(多角度)、多参数重复成像,为有效地辨认额隐窝区域复杂的局部解剖特征提供了有益的帮助。
Objective To observe the CT image features of normal frontal crypt area and to deepen the understanding of some important anatomical landmarks in frontal crypt area. Methods Sixty-nine patients (98 sides) with no frontal sinus disease and no lesion in the frontal recess were selected for 16-slice spiral CT scan (pitch 0.562, scan thickness 0.625mm, layer thickness 0.3mm) and then Coronal, sagittal and horizontal image reconstruction (thickness 0.625mm, window width + 2000HU, window level + 200HU) was performed on an image workstation. Observe the appearance rate of anatomical landmarks such as nasogastric atrium, upper attachment of the uncinate process, terminal crypt, frontal air room, upper air sac, frontal air sac and frontal sinus septum on CT images. Results The incidence of nasal cavity was 94% (92/98). The anterior superior cords participate in the inner wall, upper wall, inferior wall and posterior wall of the nasal cavity, with a single attachment point (65%, 64/98) or two attachment points (35%, 34/98 ). The single upper attachment point after the hook is mainly located in the orbital paperboard (53%, 52/98) and can also be attached to the middle turbinate (9%) or skull base (3%). The two attachment points at the upper part of the uncinate process are mainly attached to the orbital cardboard and cranial base (24%), and can also be attached to the orbital cardboard and middle turbinate (10%), only 1 side (1%) to the skull base and middle turbinate . 87% (85/98) of the hook after the upper end of the adhesion point in the orbital cardboard, and the bottom of the junction with the orbital cardboard to form a terminal recess. The prevalence of the frontal air chamber was 33% (32/98), of which type Ⅰ was the most common (23%), type Ⅱ (2%) and type Ⅲ (7%) were rare. The incidence rates of the upper air bubble, frontal air bubble and frontal sinus space were 31%, 7% and 14% respectively. Conclusion Multi-slice spiral CT achieves single-scan, multi-plane (multi-angle) and multi-parameter repeat imaging, which is helpful to effectively identify the complex local anatomic features in the frontal crypt area.