61例中耳炎咽鼓管多层螺旋CT影像解剖学研究

Anatomy and MSCT imageology of eustachian tube from 61 cases of otitis media

目的通过多层螺旋CT多平面重组重建了解中耳炎耳咽鼓管与正常耳咽鼓管的解剖关系,为临床研究提供解剖学资料。方法设61例(85耳)中耳炎患者为病变组,设鼓膜完整的15例(30耳)经专科检查、纯音测听及声导抗检查排除中耳病变且咽鼓管功能正常者作为对照组,两组均采用多层螺旋CT分别行颞骨静态及动态CT扫描,且均行多平面重组重建,重建后分别测量其骨部、软骨部开放区域、软骨部闭合区域、软骨部有效闭合区域长度,并比较两组间的影像学差异。结果对照组鼓室前段直径(9.95±1.29)mm,骨-软骨接合部直径(3.89±0.50)mm,骨部长度(20.89±1.81)mm;病变组鼓室前段直径(9.85±0.83)mm,骨-软骨接合部直径(3.92±0.37)mm,骨部长度(20.51±2.13)mm;静态CT多平面重组重建:对照组开放区域长度(10.99±0.87)mm,闭合区域长度(36.90±6.73)mm,病变组开放区域长度(8.50±0.55)mm,闭合区域长度(42.26±7.19)mm;动态CT多平面重组重建:对照组有效闭合区域长度(10.20±3.96)mm,病变组有效闭合区域长度(33.32±9.44)mm。结论中耳炎耳咽鼓管与正常耳咽鼓管骨部无明显差异;静态下病变组软骨部闭合区域大于对照组软骨部闭合区域长度;动态下对照组咽鼓管软骨部闭合区域长度减小,开放区域长度增加,而病变组闭合区域长度改变不明显。

Objective To explore an atomic relationship between normal eustachian tube and that of otitis media,through multi-plane reformation of the multi-slice helical CT（MSCT）,and provide anatomic basis for clinical application.Methods The Otitis media group consisted of 85 ears of 61 patients with otitis media.The control group consisted of 30 ears of 15 volunteers without symptoms of otitis media or abnormal findings in ET function tests.Both groups were scanned under MSCT,and then imaging data were reconstructed adopting multi-plane reformation.The bony part distance,the opening tubal distance,the closing tubal distance and the utility closing tubal distance were measured and compared in both groups.Results For control and otitis media groups,the diameters of pre-tympanic segment,of junctional portion of cartilaginous and bony,and the length of bony portion were（9.95±1.29） mm and（9.85±0.83） mm,（3.89±0.50）mm and（3.92±0.37） mm,（20.89±1.81） mm and（20.51±2.13） mm respectively.For static CT images,the length of open zone and occlusive zone were（10.99±0.87） mm and（8.50±0.55） mm,（36.90±6.73） mm and（42.26±7.19） mm respectively,however,the length of occlusive zone were（10.20±3.96） mm and（33.32±9.44） mm respectively for dynamic CT images.Conclusions There are no significant differences of the length of bony portion between otitis media and the control groups.The occlusive zone is longer in otitis media group than that in control group（P0.05） under the static CT,however,which is significantly longer in otitis media group than that in control under the dynamic CT.