基于容积CT中耳前庭窗及前庭窗龛的解剖学研究

The anatomic study of the oval window and oval window niche by the volume CT

目的探讨正常前庭窗及前庭窗龛形态学特点,为进一步研究该区相关疾病的影像学诊断提供正常值参数,为相关手术提供解剖学数据。方法收集2011年4月～2012年7月在北京同仁医院行颞骨64层螺旋CT检查,且符合纳入标准的受检者240例(480耳),并将其按年龄分为四组:儿童组(﹤18岁),青年组(18岁≦年龄﹤45岁),中年组(45岁≦年龄﹤60岁),老年组(≧60岁)。每组60例,男女各30例。采用后处理工作站Extended BrillianceTM Work-space(EBW)多平面重建,图像经标准化处理后测量前庭窗及前庭窗龛各径线、方位以及对前庭窗和面神经水平段的关系进行分类。左、右侧别间比较采用配对样本t检验,男、女性别间比较采用独立样本t检验,不同组别间比较采用单因素方差分析,设定P值﹤0.05有统计学意义。结果①前庭窗及前庭窗龛各测量值在左右侧别、男女性别及不同年龄组间比较,P值均﹥0.05,差异无统计学意义;②240例前庭窗及前庭窗龛各测量值及95%置信区间分别为(单位mm):横轴位前庭窗径长1.46±0.40(0.68～2.24);冠状位前庭窗径长1.19±0.19(0.82～1.56),前庭窗龛外口径长3.14±0.47(2.22～4.06),前庭窗龛深2.24±0.32(1.61～2.87);矢状位前庭窗径长1.73±0.33(1.08～2.38),前庭窗龛外口径长2.59±0.44(1.73～3.45),前庭窗龛深3.14±0.52(2.12～4.16)。前庭窗空间位置及95%置信区间分别为:前庭窗前后方位内倾角21.30°±7.99°(5.64°～36.96°);前庭窗上下方位外倾角42.15°±8.60°(25.29°～59.01°);前庭窗左右方位前倾角74.19°±11.10°(52.43°～95.95°)。结论容积CT可很好显示前庭窗及前庭窗龛细微结构影像解剖,结合后处理技术可准确进行量化测量,为该区异常病变的诊断及避免术中意外损伤提供可靠信息。

Objective To investigate the morphological features of the oval window and the oval window niche in subject and to provide the significant data for the future imaging diagnosis and the operations in this area. Methods The patients who underwent temporal CT scan were collected from Apr. 2011 to Jul. 2012. The 240 cases （480 sides）who met the inclusion criteria were divided into 4 groups：the child group （ 〈 18 years）, the teenager group （18 years≤ the age 〈 45 years ）, the middle age group （45 years ≤ the age 〈 60 years）, the older group （≥ 60 years）. Through the multiplanar reconstruction of the images in post-processing workstation, the measurements in the ovalwindow and the ovalwindow niche were performed. Results ① There was no statistically significant difference in the related measurements of the oval window in sides, genders and among the different groups （ P 〉 0.05）. The measurements in the oval window and the oval window niche and 95 % confidence interval were as follow： at axial plane, the length of of the oval window was 1.46 ± 0. 40（0.68±2.24） mm, at coronal plane, the length of of the oval window was 1.19±0.19（0.82-1.56） mm, the length of the niche in exterior open was 3.14±0.47（2.22-4.06） mm, the depth of the oval window niche was 2.24±0.32（1.61- 2.87） mm, at sagittal plane, the length of of the oval window was 1.73±0.33（1.08-2.38） mm, the length of the niche in exterior open was 2.59±0.44（1.73-3.45） mm, the depth of the oval window niche was 3.14±0.52（2.12±4.16） ram. The spacial position of the oval window and 95% confidence interval were as follow： the inward angle of the oval window in anterior-posterior position was 21.30°-7.99°（5.64°-36.96°） , the extraversion angle of the round window in the superior-inferior position was 42.15°-8.60°（25.29±59.01） , the anteversion angle of the round window in the left-right position was 74.19°-11.10°（52.43°-95.95°）. Conclusion The volume CT can clearly display the location and the morphology of the ovalwindow and the ovalwindow niche, with the post-processing technology, can provide more useful information for the imaging diagnosis and the operations.