Abstract:Objective: To explore the application value of low-dose CT three-dimensional reconstruction in rhinoplasty after nasal bone fracture. Methods: 80 patients with nasal bone fracture were randomly divided into two groups according to the random number table, 40 cases in each group. The experimental group 1 was scanned with low dose (50mAs) CT, and the control group 1 was scanned with standard dose (250mAs) CT. The quality of the two groups of volume rendering (VR) images was scored, and the CT dose length product (DLP) values of the two groups were recorded, and the relevant data were statistically analyzed. There were 19 cases of rhinoplasty in the above 80 patients. They were divided into two groups according to the random number table method. All the 19 patients underwent osteotomy + nasal septum correction + prosthetic ear cartilage rhinoplasty. Four weeks after operation, 10 cases in the experimental group 2 were scanned with low dose CT, and 9 cases in the control group 2 were scanned with standard dose CT. The bony nasal root point and the corresponding skin surface point on the median sagittal plane were directly marked in the software, and the distance between the two was measured. The change of distance before and after rhinoplasty was recorded. The angles of nasal frontal angle, nasal tip angle and nasal lip angle of the two groups were marked, and the angle changes were recorded. The CT dose length product (DLP) value and effective dose (ED) value of the two groups were recorded and analyzed statistically. Results: There was no significant difference in the image quality score of CT scan between the two groups in the diagnosis of simple nasal bone fracture and nasal bone fracture with maxillary frontal process fracture (P>0.05), but there was significant difference in the diagnosis of nasal bone fracture with skull base fracture (P<0.05). The radiation dose of the experimental group 1 was significantly lower than that of the control group 1 (P<0.05). There was no significant difference between the experimental group 2 and the control group 2 in the changes of the line distance of the landmark points and the angle of the nasal frontal angle, nasal tip angle and nasal lip angle before and after operation (P>0.05). The DLP and ED values of the two groups before and after operation were compared, and the difference was statistically significant (P<0.05). Conclusion: Low-dose CT scan can meet the needs of accurate diagnosis of nasal bone fracture and nasal bone fracture with maxillary frontal process fracture and preoperative and postoperative evaluation of patients with rhinoplasty after nasal bone fracture. At the same time, it can significantly reduce the radiation dose and improve the safety of scanning, which is worthy of popularization and application.
刘鹏超, 陶晓飞, 何涛, 丁智超, 李亚新, 彭恋, 韩福生. 低剂量CT三维重建在鼻骨骨折后鼻整形的应用价值[J]. 河北医学, 2023, 29(6): 952-956.
LIU Pengchao, TAO Xiaofei, DING Zhichao, et al. Application Value of Low-Dose CT Three-Dimensional Reconstruction in Rhinoplasty after Nasal Bone Fracture. HeBei Med, 2023, 29(6): 952-956.
[1] 王珮华.鼻外伤畸形的功能性鼻整形术[J].中华耳鼻咽喉头颈外科杂志,2020,55(3):298-303. [2] 高代平,莫有发,陈伟琼.低剂量CT扫描在鼻骨骨折诊断中的意义[J].中国医师杂志,2006,(S1):251-252. [3] 陈云.鼻骨低剂量多层螺旋CT扫描技术的应用价值分析[J].现代医用影像学,2017,26(5):1296-1297,1303. [4] 杨翼,戴宜君,徐忆,等.浙江健康成年汉族人外鼻形态的初步测量[J].口腔颌面修复学杂志,2018,19(2):75-78. [5] Steve Cheukwulebe,Christopher Hogrefe.The diagnosis and management of facial bone fractures[J].Emergency medicine clinics of North America,2019,37(1):137-151. [6] 胡冉,杨丽倩,蒋莉莉.鼻骨骨折患者生活质量的纵向随访及分析[J].中国中西医结合耳鼻咽喉科杂志,2021,29(6):471-475,480. [7] Ortega,Alvaro,Gauna,et al.Music therapy for pain and anxiety management in nasal bone fracture reduction:randomized controlled clinical trial[J].Otolaryngology-head and neck surgery:official journal of American Academy of Otolaryngology-Head and Neck Surgery,2019,161(4):613-619. [8] 江海丽,侯凤艳,钱宇,等.采用自体肋软骨整复歪鼻同期鼻内镜下鼻中隔偏曲矫正术1例[J].中国耳鼻咽喉颅底外科杂志,2019,25(6):680-682. [9] Jin L,Ge X,Lu F,et al.Low-dose CT examination for rib fracture evaluation:a pilot study[J].Medicine,2018,97(30):11624 [10] 华建明,陈根松,章伟敏.低剂量颞骨多层螺旋CT扫描技术的应用研究[J].中华放射医学与防护杂志,2006,26(5):530-532. [11] Lin MF,Chen CY,Lee YH,et al.Topogram-based tube current modulation of head computed tomography for optimizing image quality while protecting the eye lens with shielding[J].Acta Radiol,2019,60(1):61-67. [12] Beregi JP,Greffier J.Low and ultra-low dose radiation in CT:opportunities and limitations[J].Diagn Interv Imaging,2019,100(2):63-64. [13] 王洁.多层螺旋CT扫描诊断颅底骨折的影像学特征分析[J].哈尔滨医药,2021,41(2):86-87. [14] 王振,狄幸波,吴华,等.低剂量CT三维重建在隆鼻整形中的应用价值[J].中国辐射卫生,2011,20(2):249-251.