面神经管MSCT曲面重建在胆脂瘤型中耳乳突炎术前评价中的价值

Preoperative MSCT Evaluation of the Facial Nerve Canal with Curved Planar Reformation in Cholestoma Otitis

目的:探讨多层螺旋CT(MSCT)面神经管曲面重建(CPR)在胆脂瘤型中耳乳突炎手术前评价中的价值。方法:89例经手术和病理证实的胆脂瘤型中耳乳突炎患者术前行颞骨MSCT薄层高分辨率扫描,在三个互相垂直的平面上分别进行面神经管曲面重建,在重建图像上观察和测量面神经管解剖及邻近关系,并与横断面图像和手术所见对照。结果:81例成功行面神经管曲面重建,其中28例术中见面神经管骨质破坏,CPR像均准确显示骨质破坏的位置、形态和范围,清晰显示病变与面神经管的关系,并准确测量面神经管与其解剖标记结构间的最短距离。结论:MSCT面神经管CPR重建可为胆脂瘤型中耳乳突炎患者术前提供可靠的活体形态学观察,有效避免术中面神经损伤。

Purpose： To investigate the clinical application of the multislice spiral CT （MSCT） curved planar reformation （CPR） of the facial nerve canal in cholestoma otitis surgery. Methods： Eighty - nine patients with cholestoma otitis proven by operation and pathology were undergone MSCT scanning with 0.6mm × 40 configuration and the three orthogonal CPR images of facial nerve canal were reconstructed. The anatomy of facial nerve canal and its neighborship were evaluated and compared with that seen during the operation. Results： The CPR images were successfully obtained in 81 patients, and the canal destructions were found in 28 patients during the operation. The location, shape and extent of lesions were clearly displayed at CPR images, and the relationship with the facial nerve canal and the shortest distance between the canal and the surgical landmark were also accurately demonstrated. Conclusion： MSCT CPR images of facial nerve canal can provide important morphological observation in patients with cholestoma otitis, and are helpful for avoiding injury of the facial nerve.