高分辨CT成像在先天性中耳畸形的临床价值

Clinical value of high-resolution CT scanning for congenital middle ear malformation

目的:探讨高分辨CT成像在先天性中耳畸形的临床价值。方法:对11例先天性中耳畸形患者行1 024高分辨CT扫描、3D容积重建(3D volume rendering,3DVR)及多平面重建图像,在工作站上通过放大、旋转观察中耳解剖结构,影像图像由高年资影像科医师和耳科医师共同阅读。结果:各种重建技术对锤骨、砧骨、砧镫关节等解剖结构清楚显示,发现听小骨完全缺如3例,听小骨部分缺失或形态异常8例(其中锤砧关节融合7例、砧镫关节融合1例)。结论:中耳3DVR及多平面重建方法操作简便快捷,高分辨的图像使听小骨,特别是最小的镫骨清楚地显示,直观地再现了中耳立体结构。通过旋转观察中耳内结构接近耳科手术时显微镜的观察角度,对于外科重建听力可能性的判断和手术方案的制订有重要价值。

Objective To evaluate the clinical value of high-resolution CT scanning for congenital middle ear malformation. Methods Totally 11 patients with congenital middle ear malformation received 1 024 high-resolution CT scanning, and 3DVR and muhi-planar reconstruction were performed after scanning. The anatomical .structure of the middle ear was observed by magnifying and revolving the raster images that were evaluated by experienced radiologists and aurists. Results The reconstruction showed clearly the structures of the malleus, incus, incudostapedial joint and etc, and found 3 cases of total loss of the auditory ossicles and 8 cases of partly loss or malformation of auditory ossicles involving 7 ones of incudomalleolar joint fusion and 1 case of incudostapedial joint fusion. Conclusion 3DVR and multi-planar reconstruction may display the auditory ossicles and stapes easily and rapidly, and the obtained images can be rotated to provide different views of the ossicle simulating that by otological microscopy, and thus are of significant value for determining the possibility of reconstructing hearing and preparing operation plan.