经鼻蝶入路行斜坡区手术中蝶窦和斜坡关系的CT评价
方琼, 江安红, 庞刚, 张子轩, 邓雪飞, 陶冶, 杨见明, 韩卉
中国临床解剖学杂志 ›› 2013, Vol. 31 ›› Issue (1) : 47-50.
经鼻蝶入路行斜坡区手术中蝶窦和斜坡关系的CT评价
Evaluation of relationship between sphenoid sinus and clivus with CT in transsphenoidal approach to clival region
目的 通过对蝶窦和斜坡之间关系的CT评价，为经鼻蝶入路行斜坡区手术入路的设计提供形态学依据。 方法 30例患者行头颅64层螺旋CT薄层扫描，重建矢状位图像，选取正中矢状面，统计斜坡隐窝的发生率，观测蝶窦面积、斜坡厚度以及蝶窦后方斜坡高度，并分析三者之间的关系。 结果 73%的患者斜坡厚度小于6.0 mm，高度在9.0 mm以上。斜坡隐窝的出现率为63%，隐窝存在时斜坡厚度为（1.8±1.1）mm，10%的患者斜坡隐窝不存在的同时，斜坡厚度小于6.0 mm。蝶窦面积与斜坡厚度之间成线性负相关，其中17%的患者蝶窦面积在3 cm2以上的同时，斜坡厚度大于6.0 mm。 结论 术前对斜坡厚度及斜坡隐窝的CT评价有助于经鼻蝶入路行斜坡区手术入路的设计。
Objective The aim of this study was to evaluate the relationship between the sphenoid sinus and clivus with CT, serving to provide an anatomic basis for design of a transsphenoidal approach to the clival region. Methods A total of 30 patients underwent thin-layer head scan with 64-slice spiral CT, the sagittal images were reconstructed in AW 4.2 workspace. The incidence of the clival recess, the area of the sphenoid sinus, the thickness and height of the clivus behind the sphenoid sinus, and the relationship between them were analysed in the midsagittal plane. Results The thickness of clivus in 73% of patients was less than 6.0 mm, while the height of the clivus was more than 9.0 mm. The incidence of the clival recess was 63%. When the clival recess was present, the thickness of clivus was (1.8±1.1)mm; The thickness of clivus was less than 6.0 mm in 10% of patients with no clival recess. There was negative linear correlation between the area of the sphenoid sinus and the thickness of the clivus. The thickness of clivus in 17% of patients was more than 6.0 mm, while the area of the sphenoid sinus was more than 3 cm2. Conclusion The assessment of thickness of the clivus and the clival recess with CT is useful in designing the individualized transsphenoidal approach to the clival region.
Transsphenoidal approach / Clival region / Preoperative evaluation / CT
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