64层螺旋CT对面神经管病变的评价

Evaluation of facial nerve canal disease with 64-slice spiral CT

目的探讨64层螺旋CT及图像后处理技术对面神经管病变的诊断价值。方法回顾分析108例面神经管病变患者的CT资料,所有患者均行64层螺旋CT颞骨高分辨扫描,进行颞骨常规多平面重组,面神经管双斜位重组和曲面重组。结果面神经管骨折10例,其中鼓室段骨折8例,迷路段2例。中耳炎破坏面神经管67例,包括胆脂瘤型中耳炎60例,肉芽肿型中耳炎7例,外耳道胆脂瘤破坏面神经管9例,颞骨转移瘤破坏面神经管1例,颈静脉球增大致面神经管缺损2例。颞骨病变术后面神经管缺损19例,其中中耳癌术后1例,中耳胆脂瘤术后13例,外耳道胆脂瘤术后5例。结论64层螺旋CT颞骨高分辨扫描及图像后处理能清晰显示面神经管病变,对临床诊断和治疗有重要价值。

Objective To evaluate the diagnostic value of 64-slice spiral CT and its imaging post-processing technics in facial nerve canal disease. Methods CT data of 108 cases with the ficial nerve canal disease were analyzed retrospectively. High-resolution CT scanning was performed in all patients with 64-slice spiral CT and reconstruction of the facial nerve canal with imaging post-processing technics of regular multiplannar reconstruction（MPR）, double oblique MPR and curved multiplanner reconstruction （CPR）. Results Ten cases with fractures of the facial nerve canal, fracture involving the tympanic segment in 8 cases and the labyrinthine segment in 2 cases. Facial nerve canal bone destruction in cholesteatotampus tympanitis 60 cases（64 ears）, granuloexsudative tympanitis 7 cases, external ear canal cholesyeatoma 9 cases, metastatic tumour of temporal bone 1 case, 2 cases facial nerve canal bone defect secondary to large jugular bulb. Facial nerve canal bone defect in 19 cases because ofpostoperation of temporal bone disease, which including middle ear cancer 1 case, cholesteatotampus tympanitis 13 cases, external ear canal cholesyeatoma 5 cases. Conclusion The disease of facial nerve canal can be demonstrated clearly by 64-slice spiral CT high-resolution scanning and its post-processing imaging, which contribute much to the clinical diagnosis and treatment.