高分辨率CT最大密度投影对慢性化脓性中耳炎听骨链病变的诊断价值

Evaluation of maximum intensity projection in HRCT in the diagnosis of the destruction of ossicular chain in chronic otitis media

目的:通过高分辨率CT(HRCT)最大密度投影(MIP)对正常听骨链的观察,探讨其对慢性化脓性中耳炎听骨链病变的诊断价值。方法:对68例(136耳)患者进行HRCT扫描,自由模式分别沿各听小骨长轴行多平面重组,对重组图像行MIP重建,正常耳观察听骨链的结构形态,病变耳观察听骨链破坏情况并与手术结果比较。结果:54侧正常耳的听小骨MIP显示了听小骨的细微结构,还反映了听小骨之间的关系。慢性化脓性中耳炎82耳,MIP图像显示胆脂瘤型中耳炎41耳,39耳有听骨破坏,肉芽肿型中耳炎25耳,5耳有听骨破坏,单纯化脓性中耳炎16耳,未见骨质破坏。术中见胆脂瘤型中耳炎39耳骨质破坏,肉芽肿型中耳炎6耳有骨质破坏,单纯型无骨质破坏。结论:HRCT通过MIP可以清晰地显示正常听骨链及其空间结构,与轴位及冠状位图像相结合可以提高术前对听骨链病变的诊断率,有助于手术方式的制定。

Objective：To observe the ossicular chain structure with maximum intensity projection（MIP） and to evaluate the diagnostic value of it in the destruction of ossicular chain in chronic otitis media（COM）. Method：Sixtyeight patients （136 ears） were scanned with HRCT. T.he original data was processed with MIP reconstruction technique. The images of the ossicular chain structure in normal ears were observed, while the images in suffering ears were compared with the findings in operation. Result： In normal ears,the ossicular chain structure was shown clearly by MIP, which can also display three -dimensional images of the ossicular chain. In the suffering ears of chronic otitis media of cholesteatoma type, granuloma type and simple type, MIP displayed the destruction of ossicular chain in 39 ears, 5 ears and 0 ear respectively, which was observed in 39 ears, 6 ears and 0 ear respectively in operation. Conclusion.. MIP technique in HRCT can display the ossicular chain spatial structure clearly , which is very helpful to evaluate the destruction of ossicular chain in chronic otitis media（COM） and to make accurate operation plan.