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目的:研究多层螺旋CT(MSCT)及其重建技术在第一、二鳃弓综合征的诊断及鉴别诊断中的应用价值。方法:回顾性分析两年内经临床证实的26例患儿的MSCT资料,包括原始轴位、多平面重组(MPR)及容积重组(VR)图像。结果:MSCT发现的26例第一、二鳃弓综合征中,右侧13例,左侧13例。下颌骨均有不同程度的发育异常,以升支缩短为主,其中Ⅰ型3例,ⅡA型12例,ⅡB型7例,Ⅲ型4例。9例颧骨发育不良,3例上颌骨发育不全。大口畸形22例,耳廓畸形9例,21例有1~4个附耳和(或)皮赘,外耳道狭窄2例,外耳道闭锁7例,听小骨畸形7例。咀嚼肌及腺体发育不良,以咬肌及腮腺为代表,13例无咬肌组织,10例咬肌不同程度变小;11例无腮腺组织,10例不同程度腮腺发育不良。1例伴小下颌畸形,3例两侧侧脑室稍宽,余颅内结构未见明显异常。26例均无眼部异常及颅缝早闭征象。结论:MSCT及其重建技术不仅可以确诊本病,而且对鉴别诊断及外科手术有重要的临床意义。
Objective: To study the value of multi-slice spiral CT (MSCT) and its reconstruction in the diagnosis and differential diagnosis of the first and second branchial arch syndrome. Methods: MSCT data of 26 clinically confirmed children over two years were retrospectively analyzed, including primary axial, multiplanar reconstruction (MPR) and volumetric reconstruction (VR) images. Results: Among 26 cases of first and second branchial arch syndrome detected by MSCT, 13 cases were found on the right and 13 cases on the left. There were different degrees of dysplasia in the mandible, with ascending and descending shortening, of which 3 were type Ⅰ, 12 type ⅡA, 7 type ⅡB and 4 type Ⅲ. 9 cases of zygomatic dysplasia, 3 cases of maxillary hypoplasia. Large deformity in 22 cases, auricular deformity in 9 cases, 21 cases of 1 to 4 with the appendage and (or) skin tag, external auditory canal stenosis in 2 cases, external auditory canal atresia in 7 cases, hearing small bone deformity in 7 cases. Masticatory muscle and glandular dysplasia, represented by masseter and parotid gland, mastectomy in 13 cases and masseter muscle in 10 cases. The number of masseter muscle decreased in 11 cases, parotid gland in 11 cases and dysplasia of parotid gland in 10 cases. 1 case accompanied by small mandibular deformity, 3 cases of lateral ventricle slightly wider than the rest of the intracranial structure showed no significant abnormalities. None of the 26 patients had ocular abnormalities and signs of craniosynostosis. Conclusion: MSCT and its reconstruction technique can not only diagnose the disease, but also have important clinical significance in differential diagnosis and surgery.