螺旋CT三维成像在慢性化脓性中耳炎诊断中的应用

The application of spiralCT threedimensional reconstruction in chronic otitis media

目的探讨螺旋ＣＴ三维成像在慢性化脓性中耳炎诊断中的应用。方法比较２２耳慢性化脓性中耳炎（３耳单纯型，１９耳胆脂瘤型）螺旋ＣＴ三维成像（ｓｐｉｒａｌＣＴｔｈｒｅｅｄｉｍｅｎｓｉｏｎａｌｉｍａｇｅ，ＳＣＴ３ＤＩ）与临床手术中所见。结果单纯型中耳炎ＳＣＴ３ＤＩ未见骨质破坏，与手术中探查相符。胆脂瘤型中耳炎ＳＣＴ３ＤＩ示：鼓室、鼓窦内软组织影和骨质破坏，听骨链移位和破坏，严重者破坏鼓室盖、面神经管、外半规管和乙状窦板等，与手术中所见基本相符。结论ＳＣＴ３ＤＩ比其他影像方法在慢性化脓性中耳炎诊断和耳显微外科中更有应用价值。

Objective To study the use of spiralCT threedimensional reconstruction in chronic otitis media. Methods The images of spiralCT threedimensional reconstruction (SCT3DI) and surgical findings in 22 ears with chronic otitis media were compared. Results The lesions showed in SCT3DI were in accord with those seen in the operation. There were no bone erosion in the 3 ears with simple type otitis media, and the 19 ears with cholesteatoma showed: abnormal softtissue and bony erosion in the tympanic cavity and antrum; dislocation and disruption of the ossicular chain; and showed disruption of sigmoid sinus plate, tegmen tympani, semicircular canal and facial nerve canal in severe cases. Conclusion The spiralCT has more superiority over traditionalCT in diagnosis of lesions in chronic otitis media before operation.