虚拟耳镜对慢性中耳炎听骨链病变的诊断价值

Evaluation on the virtual endotoscope for the diagnosis of ossicular chain lesions accompanied with chronic otitis media

目的探讨虚拟耳镜观察对慢性中耳炎听骨链病变的诊断价值。方法112例(128耳)慢性化脓性中耳炎患者,高分辨率CT扫描获取病变部位的原始图像数据,经三维重建后,以虚拟耳镜方式观察听骨链病变情况,然后与手术结果进行比较分析。结果128只患耳中,胆脂瘤性中耳炎55耳,非胆脂瘤型慢性化脓性中耳炎73耳。与手术结果比较,虚拟耳镜对慢性化脓性中耳炎听骨链病变的诊断敏感度、特异度及准确度分别为93.75%、81.25%、90.63%。结论虚拟耳镜能清晰显示听骨链结构及其空间关系,可以提高听骨链病变的术前诊断效率,有助于化脓性中耳炎手术方案的制定。

Objectiv To explore the value of virtual endotoscope for the diagnosis of ossicular chain lesions accompanied with chronic otitis media. Methods One hundred and twelve cases （128 ears） with chronic purulent otitis media were undergone high resolution CT scanning to collect the original image data from the focus in middle ear, followed by 3-dimensional reconstruction to process these images for evaluating the possibly presented lesions with the ossicular chain. Then, a comparative analysis was made on the virtual endotoscopic findings in a correlative consideration with that actually found during the operation on the middle ear. Results Among the 128 ears with chronic otitis media, 55 were diagnosed with cholesteatoma in the middle ear and the other 73 diagnosed as no cholesteatoma type of chronic purulent otitis media. When compared with the findings observed during the operation, calculated statistically was the value of virtual endotoscope in the diagnosis of ossicular chain lesions accompanied with chronic otitis media based showing its diagnostic sensitivity, specificity and accuracy being 93.75%, 81.25% and 90.63% respectively on the 3-D image reconstructing procedures of CT scanning. Conclusions Virtual endotoscope can clearly display the figure of ossicular chain and its spatial relationship with other structures in the middle ear and provide more detailed information to improve the preoperative diagnostic levels for ossicular chain lesions and to prepare a more practical strategy for surgical treatment on chronic otitis media.