成人锤砧关节和砧镫关节的正常HRCT表现及临床意义

Normal HRCT manifestations of incudomalleolar joint and incudostapedial joint in adults

目的:探讨成人锤砧关节和砧镫关节的正常HRCT表现及临床意义。方法:回顾性分析46例成人的正常锤砧关节和砧镫关节HRCT图像,对其形态进行影像学分类;对可能存在的两侧锤砧关节或砧镫关节形态不对称情况进行统计;对锤砧关节和砧镫关节间隙进行影像学测量,利用统计学软件计算得到一组正常值范围。结果:锤砧关节HRCT表现为3种形态:均匀的弧形(77耳,83.7%)、锯齿样(9耳,9.8%)和喇叭口样(6耳,6.5%);砧镫关节形态为2种:直接连接(31耳,33.7%)和间接连接(61耳,66.3%)。46例受检者中,两侧锤砧关节形态不对称5例(10.9%);砧镫关节形态不对称3例(6.5%)。对横断面上的锤砧关节和镫骨斜位上的砧镫关节间隙的测量结果分别为(0.45±0.10)mm和(0.43±0.12)mm。结论:锤砧关节和砧镫关节的正常HRCT表现可为特殊情况下诊断锤砧关节和砧镫关节脱位提供较为客观的参考依据。

Objective： To approach the normal manifestations of incudomalleolar joint and incudostapedial joint in adults,and to evaluate their clinical values. Methods：Forty-six adults＇ normal HRCT images of incudomalleolar joint and incudostapedial joint were analyzed retrospectively,their forms were classified; the asymmetry of incudomalieolar joint and incudostapedial joint was observed, and the asymmetrical cases were counted;the joint spaces were measured. Statistical analyses of measured results were made. Results：There were three types of incudomalleolar joint, including uniform arc （77 ears, 83.7%）, serrate （9 ears, 9.8%） and trumpet--shaped types （6 ears, 6.5%）. There were two types of incudostapedial joint, directly joined joint （31 ears, 33.7%） and indirectly joined joint （61 ears, 66.3%）. Of the forty-six cases, there were 5 cases （10.9%） with asym- metrical incudomalleolar joints and 3 cases with asymmetrical incudostapedial joints （6.5 %）. The measuring results of incud- omalleolar joints on standard axis and that of incudostapedial joints on oblique MPR images were （0.4± 0.10）mm and （0.43±0.12） mm respectively, the standard deviations were 0.10 mm and 0.12 mm respectively. Conclusion： The normal HRCT manifestations of incudomalleolar joint and incudostapedial joint could provide objective foundations for the diagnosis of incudomalleolar joint and incudostapedial joint dislocation in some special conditions.