中耳结构及中耳病变的虚拟耳镜表现

Virtual otoscopy of middle ear structure and pathology

目的 探讨基于高分辨率CT数据的虚拟耳镜显示听骨链及颞骨重要解剖结构的能力。方法 选取 5 0例患者行颞骨薄层CT检查 ,其中 17例中耳炎患者接受了手术治疗。螺旋CT获取原始图像数据 ,经软件三维重建后 ,以虚拟耳镜方式观察中耳等结构。结果 虚拟耳镜能够清晰显示听小骨、面隐窝、圆窗龛、面神经嵴等正常鼓室各壁的精细结构 ;以及在中耳炎、外伤、颞骨畸形等情况下的听骨链移位、中断、缺失及各种畸形。虚拟耳镜在诊断单纯性中耳炎听骨链的连续性上具有较高的准确性 ,11耳中有 10耳与手术探察的结果一致 ,而胆脂瘤型 6耳中有 3耳与手术探察结果不一致。结论 虚拟耳镜有多种优势 ,可以帮助术前评估中耳诸结构 。

Objective To assess the value of high resolution CT data of the temporal bone for the virtual endoscopic (VE) visualization of the ossicular chain and the temporal bone Methods Fifty patients with suspected lesions of middle ear underwent a high resolution CT of the temporal bone with VE ,seventeen patients were subsequently operated CT examinations of the temporal bone were carried out using spiral equipment and endoscopic 3D processing was carried out on a separate workstation equipped with a flying through program Results VE is valuable for the evaluation of ossicular dislocation, disruption and ossicular lysis, morphological anomalies of the malleus, incus, and stapes, as well as for evaluation of normal middle ear structures with high detail The VE assessment in detecting ossicular disruption of chronic otitis media match the operation exploration perfectly (10 in 11 ears), whereas only 3 in 6 ears of cholesteatoma match the operation exploration Conclusions This image processing method can be used pre operatively for the individual planning, simulation, and post operatively for assessment of the position of implants