胸部多排螺旋CT扫描在肋软骨隆鼻术整形中的临床应用研究

目的：探讨胸部多排螺旋CT扫描在肋软骨隆鼻术中的应用价值。方法：收集符合纳入标准120例拟行自体肋软骨隆鼻术患者，都进行了胸部多排螺旋CT术前检查，并进行多种三维重建分析自体肋软骨是否符合手术标准，部分病例进行了术后CT复查评估。结果：CT准确评估肋软骨无钙化（1级）28例和轻度钙化（2级）62例，均可行自体肋软骨隆鼻术；中度钙化（3级）23例中12例可用自体肋软骨行隆鼻术，剩余7例全部重度钙化（4级）患者直接放弃肋软骨而采用耳软骨等替代进行隆鼻术。同时还发现叉状肋3例、肋软骨部分融合7例，镜面右位心伴内脏扭转1例，肺部占位病变2例。结论：多排螺旋CT及多种三维重建对拟选择自体肋软骨行隆鼻术的患者是术前首选的影像学检查方法，可以准确评估自体肋软骨是否存在钙化及程度，并能精准测量各肋软骨实际走行、长度、宽度及厚度，能够为肋软骨隆鼻术提供可靠的术前影像信息，同时还可以用于术后评估移植效果及排查并发症等。

Clinical Application of Multi-slice Spiral CT Scan in Chest for Costal Cartilage Augmentation Rhinoplasty

objective:To evaluate the value of multislice spiral CT-Chest Scan in costal cartilage augmentation rhinectomy. Methods: 120 patients undergoing autologous costal cartilage augmentation rhinorrhea were examined by multislice spiral CT before operation, and various three-dimensional reconstruction was performed to analyze whether the autogenous costal cartilage was in accordance with the surgical standard. Some cases were reviewed and evaluated by CT after operation. Results: CT accurately evaluated 28 cases of non-calcification of costal cartilage(grade 1) and 62 cases of mild calcification(grade 2), all of which could be performed augmentation rhinectomy with autologous costal cartilage. 23 cases of moderate calcification(grade 3), of the 23 cases, 12 were avaiable. The remaining 11 cases and all severe calcification(grade 4) 7 cases gave up costal cartilage directly and performed augmentation rhinoplasty with ear cartilage replacement. At the same time, 3 cases of forked ribs, 7 cases of partial fusion of costal cartilage, 1 case of endoscopic right heart with visceral torsion and 2 cases of pulmonary space occupying lesions were also found. Conclusion: multislice spiral CT and various three-dimensional reconstruction are the first choice of imaging examination for patients who want to perform augmentation rhinectomy with autologous costal cartilage. It can accurately evaluate whether there is calcification and degree of autochial cartilage, and can accurately measure the actual course, length, width and thickness of each costal cartilage, which can provide reliable preoperative imaging information for costal cartilage augmentation rhinectomy. At the same time, it can also evaluate the effect of transplantation and detect complications after operation and so on.