| BackgroundPterygopalatine space was the interval palatal side an osseous lacuna of deep zone, through nine natural channel to cranial cavity inside and outside were interlinked, tumor and other lesions could occur, or infringement of the gap, and then further spread along the pterygopalatine space communications. Spiral CT was a powerful 3D reconstruction function, such as multiplanar reconstruction (MPR) and volume representation (VR) and so on, especially the spiral CT showed good ability of bony structure, maked the pterygopalatine space communications and its surrounding structure could fully display on CT images, its fine structure could also be displayed more clearly.ObjectiveUsing spiral CT multiplanar reconstruction (MPR) and volume representation (VR) 3D reconstruction technique, observed the pterygopalatine space communications and the location of the lesions on CT images, the direction, length, diameter and the size of the openings and changes, and the pterygopalatine space communications with sphenoid sinus surrounding structures such as the location of the relationship, pterygopalatine space and the surrounding region lesions mutually spread provide anatomical basis for clinical diagnosis.MethodsCollected during January 2010 to January 2015, Zhumadian city hospital on facial images of spiral CT scanning of adults (>18 age), no pterygopalatine space and the communications lesion to normal images of 100 cases and lesions with hospitalization of 100 cases of abnormal image. Will be inspectors all the original image data input the CT 3D reconstruction workstations, used ADW 4.2 reconstruction software multiple planar reconstruction (MPR) and volume representation (VR) reconstruction image post-processing software. Observed pterygopalatine space communications and the morphological changes of the pathological change, used 3D reconstruction of the workstation software system, measured the length of the pterygopalatine space communications and its pathological changes, diameter and the size of the openings, etc. Using SPSS 13.0 software for statistical data from processing, measurement data using mean±standard (x±s) deviation.Results1. Foramen rotundum under since the former backwards on the connecting with pterygopalatine space and cranial fossa, the anterior, posterior opening diameter and length were (3.47±0.74) mm, (3.18±0.58) mm, (4.06±0.85) mm respectively, between the anterior opening diameter and posterior opening diameter had significant difference (P<0.05). The location relationship between the framen rotundum and the sphenoid sinus was divided into para-sinus, sinus completely inside and part of the sinus, incidence were 23% (46/200),36% (72/200),41% (82/200) respectively, the three incidence had significant difference (P<0.05).2. Pterygoid canal connected pterygopalatine space form back to before clearance with foramen lacerum, the anterior, middle, posterior opening diameter and length were (3.56±0.70) mm, (1.41±0.54) mm, (1.64±0.51) mm, (14.50±1.50) mm respectively, and anterior, middle, posterior opening diameter had significant difference (P<0.05). Pterygoid canal and the relationship between the location of the sphenoid sinus was divided into the bottom of the sinus, sinus completely inside and part of the sinus, incidence were 15%(30/200),29%(58/200),56%(112/200) respectively, the three incidence had significant difference (P<0.05).3. Sphenopalatine foramen since the outside to the inside of the connected with pterygopalatine space and nasal cavity, anteroposterior diameter and superoinferior diameter were (6.35±1.71) mm, (5.27±1.24) mm respectively, it had significant difference (P<0.05). Sphenopalatine foramen and the relationship between the location of the nasal passages were divided into open on the nasal passages in the nasal passages, and in the nasal passages, incidence were 67%(134/200),4%(8/200), 29%(58/200), the three incidence had significant difference (P<0.05).4. Inferior orbital fissure from the forward under after connecting pterygopalatine space and orbital cavity, the length, maximum width size, minimum width size were (28.16±1.03) mm, (6.01±0.33) mm, (1.32±0.41) mm respectively, maximum and minimum width diameter between wide diameter had significant difference (P< 0.05).5. Pterygomaxillary fissure from the inside to the outside connected the pterygopalatine space and temporal fossa, anteroposterior diameter and superoinferior diameter were (3.68±0.65) mm, (22.96±2.12) mm respectively, there were significant differences between anteroposterior diameter and superoinferior diameter(P<0.05).6. Greater palatine canal and lesser palatine canal connected the pterygopalatine space and oral cavity, the superior, central and inferior opening diameter of greater palatine were (2.71±0.60) mm, (3.25±0.87) mm, (7.01±1.53) mm respectively, it had significant difference (P<0.05). The superior, central and inferior opening diameter of lesser palatine canal were (0.91±0.30) mm, (0.95±0.33) mm, (1.31±0.57) mm respectively, it had significant difference (P<0.05). The length of greater palatine canal and lesser palatine canal were (12.68±2.22) mm, (14.20±2.96) mm respectively, it had significant difference (P<0.05).7. Palatovaginal canal and vomerovaginal canal were connected under backwards from the former the pterygopalatine space and pharyngeal cavity, the length of the palatovaginal canal and vomerovaginal canal were (11.17±0.35) mm, (11.38±0.54) mm respectively, it was no significant difference (P>0.05). The anterior, middle, posterior opening diameter of palatovaginal canal were (2.01±0.33) mm, (1.04±0.19) mm, (1.59±0.24) mm respectively, it had significant difference (P<0.05). Palatovaginal canal and the relationship between the location of the sphenoid sinus into the bottom of the sinus and parts within the sinus type, incidence was 89% (178/200),11%(22/200) respectively, it was significant differences (P<0.05).8. Pterygopalatine space by the invasion of nasopharyngeal carcinoma patients, whether there was a pterygopalation space communication again transfer between the survival rate no significant difference (P>0.05). Abnormal bone fibre hyperplasia assault pterygoid canal, foramen rotundum, maked its narrow and no influence to the pipeline between all had significant difference (P<0.05).Conclusion1. Spiral CT 3D reconstruction techniques such as multiplanar reconstruction (MPR) and volume representation (VR), intuitive, stereo display the pterygopalation space communication and the characteristics of the pathological changes of anatomy was the study of pterygopalation space the spread of the lesion and its surrounding structure are important means.2. Pterygopalation space communication and its pathological changes of CT 3D reconstruction observation, could be found early pterygopalation space and the surrounding bone changes of the structure, timely find lesions, for clinical diagnosis and surgical plan to provide the objective basis of science. |
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