| Objective: The cranio-orbital junction area has relatively many nerves and blood vessels,and it is also one of the most complicated areas for the treatment of skull base diseases,making the diagnosis and treatment of cranio-orbital junction diseases a research hotspot.This study introduces three-dimensional reconstruction technology to the microanatomy of the optic canal related structures,clarifies the relationship between the optic canal and the surrounding anatomy,and discusses the application effect of the three-dimensional reconstruction technology in the microanatomy of the optic canal related structures.It is an optic canal fracture.The reconstructed clinical diagnosis and treatment provide a reference basis.Methods: 38 patients with unilateral TON from May 2018 to August2020 were selected as subjects.All patients were treated with complete examinations after admission and were treated with optic nerve decompression.All patients were treated with high resolution CT(HRCT).)Orbital scan,and use the obtained data and images to complete the image and data reconstruction by the imaging center workstation;the measurement data includes: the length of the healthy side optic nerve canal wall,the cranial opening,the orbital opening,the vertical diameter,the transverse diameter and the cross-section of the middle part of the canal Area level;after the above operations,the status of the optic canal fracture on the affected side is classified,and different reconstruction methods are used for different types to observe the detection of the optic canal fracture on the affected side;the anatomical structure of the optic canal on the healthy side is used as a control Draw the receiver operating characteristic curve(ROC)curve,and analyze the diagnostic efficiency(sensitivity,specificity)of the three-dimensional reconstruction technology(axial CT image,MPR)in the anatomy of the optic canal.All data in this study were processed by SPSS22.0 software.Results:1.38 patients with ton successfully completed the operation,31 patients were successful,and the success rate was 81.58%.7 patients were not clear because of serious injury or optic nerve tube sign,and 5 patients including those who did not find optic canal were not clearly found,and insufficient decompression was found;2 patients were found to have cerebrospinal fluid rhinorrhea in different degrees;4 patients were accompanied with orbital apex syndrome;2 patients had transient visual acuity decline;2.The length of outer wall of optic nerve tube was(10.59±2.15)mm The length of the upper wall is(9.28±0.83)mm;the length of the inner wall is(12.56±1.63)mm;the length of the lower wall is(10.58±2.45)mm.Meanwhile,the mean and vertical diameter of the central part of the optic nerve tube were the smallest under the micro anatomy of the optic nerve tube under HRCT,respectively(4.37±0.53)mm,(4.41±0.55)mm;the comparison of orbital,middle and craniofacial transverse and vertical diameter was statistically significant(P<0.05);3.43 eyes of 38 patients had optic nerve tube fractures,including 21 medial wall fractures,12 lateral wall fractures,7 upper wall fractures One case was optic column fracture and 2 cases were multiple fractures.Among the patients,8 cases were complicated with other fractures such as orbital wall,14 cases of sphenoid sinus effusion and 5 cases of optic nerve thickening.The first two types of fracture were concave fracture and linear fracture respectively;according to the fracture location,38 cases of optic nerve tube fracture were classified according to the fracture location,and the first two were: Intratube fracture and orbital fracture;4.under three-dimensional reconstruction,the direct signs of optic nerve tube fracture HRCT were continuous interruption of optic nerve tube bone and fracture occurrence Some patients may have hematoma when they are displaced to different degrees;indirect signs are sphenoid sinus effusion and optic nerve thickening,some patients with sphenoid sinus hematoma,optic nerve compression,thickening and bending;5.In order to further analyze the effect and value of 3D reconstruction technology in the anatomy of optic nerve tube,ROC curve was introduced in this study,and the anatomical structure of the contralateral optic nerve tube was used as the "gold standard",and the ROC curve was drawn based on the control variable method,The results showed that the sensitivity of axial CT images combined with MPR in the anatomy of optic nerve tube was higher than that of single axial CT and MPR(P < 0.05);The specificity was lower than that of single axial CT and MPR(P < 0.05).Conclusion:1.The cross-sectional area of the middle part of the optic canal is relatively small,and it is also the most narrow part of the optic canal.Axial CT images obtained by HRCT scanning combined with MPR can effectively improve the detection effect of optic canal fracture,and timely and accurately find the location and state of optic nerve fracture;2.Through three-dimensional reconstruction technology can improve the diagnostic sensitivity,more accurately grasp the sufficiency of optic canal decompression,can guide clinical surgery,but in view of its specificity,should be combined with axial CT image combined with MPR and other methods,play different imaging advantages,for clinical diagnosis to improve reliable reference. |
PDF Full Text Request