ABSTRACT
Objective To study the normal microanatomy and HRCT findings in nasal bone part which is easy to be confused with the bone fracture, thus increasing the diagnostic accuracy of nasal bone fracture. Methods CT findings were compared between two groups 60 volunteers as normal group and 30 cases with nasal bone fracture as trauma group, which were all performed with HRCT in transverse and coronal scans to find the differences. Results Three experienced radiologists observed the films of the normal group in blind. 54 cases were diagnosed normal, 3 were suspected to have fracture, and 3 misdiagnosed as fracture. (1) There were some normal nasal structures which were susceptible to be confused with fracture, such as bone suture, internasal aperture, intersuture bone, and normal variations. (2) On transverse and coronal scan, nasal-maxillary suture demonstrated various characteristics, including 57 cases and 3 cases of inflated type, 39 and 5 of occluded type, 31 and 6 of intersuture bone, 16 and 34 of thin bony shapes, respectively. (3) Sometimes the extremity of outside was too depressed or flat which was related with the development, and it included 12 cases in left and 13 in right of inner alcula type, 4 in left and 4 in right of outer raised shape on coronal images, which were easily confused with fragment of fracture. But the conformation and structure were intact on transversal images, thus fracture could be excluded. Conclusion The understanding of morphological structure and characterized imaging findings can reduce the incidence of clinical misdiagnosis. Nasal bone fracture is not rare in facial trauma, and the following points should be paid attention to: 1.Normal nasal structures and variations of the nasal bone. 2.The scanning methods with HRCT. 3.Combination of the transversal and coronal scan can reinforce and testify with each other.