高分辨率CT容积重建对内耳畸形的诊断价值

Diagnostic value of high-resolution computed tomography imaging in congenital inner ear malformations

目的:通过高分辨率CT(HRCT)容积重建(VR)对正常内耳形态的观察,探讨其对先天性内耳畸形的诊断价值。方法:对10例(20耳)无耳部疾患者(对照组)和7例(11耳)先天性内耳畸形患者(病变组)行HRCT扫描,利用容积漫游技术对内耳骨迷路重建。对照组观察内耳骨迷路的正常结构,病变组观察内耳畸形情况。结果:正常耳VR图像不但显示了内耳骨迷路的细微结构,而且还反映了各结构之间的关系;病变耳立体显示了畸形部位及程度。11耳患耳中Mondini型7耳次;前庭及半规管畸形3耳次;前庭导水管扩大7耳次,其中6耳次伴随其他畸形;内耳道畸形2耳次且均伴随其他畸形。11耳畸形中9耳HRCT横断面图像和平面重建(MPR)冠状位图像、VR图像均可以清晰地显示畸形的部位和程度,其中VR图像可以直观、立体地显示畸形的空间形态结构;2耳水平半规管短小畸形患者VR图像较断面图像更好地显示了畸形的部位和程度。结论:VR三维重建可以立体显示正常内耳骨迷路的形态,直观显示内耳畸形的程度及病变位置,对内耳畸形的诊断具有重要的辅助价值。

Objective：To observe the inner ear structure with volume rendering （VR） reconstruction and to evaluate the role of high-resolution computed tomography（HRCT） in congenital inner ear malformations. Method： HRCT scanning was performed in 10 patients （20 ears） without ear disease （control group ）and 7 patients （11 ears） with inner ear malformations （IEM group） and the original data was processed with VR reconstruction. The inner ear osseous labyrinth structure in the images generated by these techniques was observed respectively in the normal ears and malformation ears. Result：The inner ear osseous labyrinth structure and the relationship was displayed clearly in VR imaging in the control group,meanwhile, characters and degree of malformed structure were also displayed clearly in the IEA group. Of seven patients （11 ears） with congenital inner ear malformations, the axial, MPR and VR images can display the site and degree in 9 ears. VR images were superior to the axial images in displaying the malformations in 2 ears with the small lateral semicircular canal malformations. The malformations included Mondini deformity （7ears）, vestibular and semicircular canal malformations （3 ears）, vestibular aqueduct dilate （7 ears, of which 6 ears accompanied by other malformations ） , the internal auditory canal malformation （2 ears, all accompanied by other malformations）. Conclusion： HRCT can display the normal structure of bone inner ear through high quality VR reconstructions. VR images can also display the site and degree of the malformations three-dimensionally and intuition-isticly. HRCT is valuable in diagnosing the inner ear malformation.