64排CT三维透明化重组在内耳畸形诊断中的应用

The Value of 64-slice Spiral CT with 3D Transparency Reconstruction in the Diagnosis of Inner ear Malformation:Analysis of 32 Cases

目的探讨三维透明化重组在内耳畸形诊断中的应用价值,为先天性内耳疾病提供准确的影像诊断和临床治疗信息。资料与方法回顾32耳内耳畸形的64排高分辨率CT(HRCT)容积数据,行三维透明化重组处理,按内耳畸形分类总结三维透明化重组方法及影像表现。结果 32耳的三维透明化容积再现(VR)图像结合透明化多平面重组(MPR)图像均能很好揭示内耳畸形病变部位及程度,内耳病变整体显示方面及蜗窗、前庭窗、半规管等细节病变显示中透明化VR像及透明化MPR像明显优于轴位像及普通MPR像;在耳蜗内部结构的显示中,透明化MPR、轴位像及普通MPR像优于透明化VR像。32耳先天内耳发育畸形有以下几种:耳蜗未发育(2耳);共同腔畸形(4耳);不完全分隔Ⅰ型(2耳,2例患者对侧耳均为共同腔畸形);不完全分隔Ⅱ型(即Mondini型)(16耳,多合并前庭、半规管及前庭导水管畸形);单纯前庭-半规管畸形(2耳);单纯前庭导水管扩大(6耳)。结论三维透明化个性重组能准确评价内耳先天性疾病的类型和程度,为临床治疗提供重要的参考依据。

Objective To investigate the role of 3D transparency reconstruction in displaying the inner ear malformation. Materials and Methods Thirty-two cases of inner ear malformation were analyzed retrospectively. The data of 64 slice HRCT were processed using 3D transparency reconstruction. The imaging findings were summarized according to the categorization of the disease. Results The malformations included cochlear aplasia（2 ears）,Common cavity deformity（4 ears）,incomplete partition I（2 ears）,incomplete partition Ⅱ（Mondini deformity）（16 ears）,vestibular and semicircular canal malformations（3 ears）and vestibular aqueduct dilate（6 ears）.The site and degree of inner ear malformation were displayed clearly by 3D transparent reconstruction imaging and MPR transparent imaging. Transparent MPR and VR were better than general MPR and the axial images in showing inner lesions and cochlear window,vestibular window,semicircular canals dorsally. MPR transparency,general MPR and axial images were better than transparency of VR in showing the internal structure of the cochlea. Conclusion 3D transparency reconstruction can accurately evaluate inner ear malformation, which is valuble in clinical therapy.