常規副鼻竇電腦斷層之曲面重建技術在齒源性上頷竇炎的應用

The Application of Curved Multiplanar Reformation Technique of Routine Paranasal Sinus CT in Odontogenic Maxillary Sinusitis

劉德彥(De-Yan Liu)；楊志明(Chih-Ming Yang)；蔡長諭(Chang-Yu Tsai)；張庭維(Ting-Wei Chang)；林偉哲(Wei-Che Lin)；詹繕合(Shan-Ho Chan)；李榮輝(Jung-Hui Li)

副鼻竇 ； 電腦斷層 ； 齒源性上頷竇炎 ； 曲面重建 ； paranasal sinuses ； computed tomography ； odontogenic maxillary sinusitis ； curved multiplanar reformation

中華放射線技術學雜誌

42卷2期（2018 / 06 / 01）

103 - 108

繁體中文

本研究主要是探討常規副鼻竇電腦斷層檢查，以曲面重建（curved multiplanar reformation, CMPR）技術，評估曲面影像應用於齒源性上頷竇炎（odontogenic maxillary sinusitis）的臨床診斷價值及意義。從105年11月至106年3月共計11位受檢者，執行無注射顯影劑掃描後，以取得的原始資料（raw data）經過後處理程序組成曲面影像。結果發現：上頷竇底部與相鄰上頜牙及周圍組織的細微解剖構造皆可精確顯示，亦可同時觀察牙齒之病變。臨床上開立副鼻竇檢查醫囑，其內容通常未提及牙齒因素，若經由CMPR技術的合併應用，即可提供更完整、直視化的上頷鼻竇及牙齒相關的影像資訊，對於放射科及臨床醫師在齒源性上頷竇炎的鑑別判斷，能儘早獲得致病因之相關證據，進而完成完整包含齒源性病因分析之檢查結果報告，幫助患者減少不必要的重複性檢查且即時接受適當治療。

This study aims mainly to explore the curved multiplanar reformation (CMPR) technique adopted during routine paranasal sinus CT and to evaluate clinical diagnostic values and significance of the curved multiplanar images when applied to odontogenic maxillary sinusitis. A total of 11 subjects completed the scan without the administration of the contrast medium in order to obtain the raw data between November 2016 and March 2017 and the raw data went through post-processing to form curved multi-planar images. Results showed that subtle anatomical structures of the bottom of the maxillary sinus and the adjacent maxillary teeth and surrounding tissues could be precisely displayed and dental disease could be observed at the same time. In a clinician's order for para-nasal sinus examination, it usually does not include dental factors. By combining the CMPR technique, more complete and visualized image data on the maxillary sinus and the teeth may be provided. It helps the radiologist and the clinician identify odontogenic maxillary sinusitis and obtain related pathogenic evidence as soon as possible to accordingly render a complete report containing examination results that cover odontogenic cause analysis. Patients do not have to go through unnecessary repeated exams and receive appropriate treatment in real time.