高分辨率CT(HRCT)骨密度测量法在耳硬化症中的诊断价值

The Diagnostic Value of HRCT in Bone Mineral Density Measurements of Otosclerosis

目的讨论在耳硬化症的诊断中,高分辨率CT(HRCT)骨密度测量法的使用价值。方法选取2013年2月到2013年3月间于我院治疗的耳硬化患者(实验组)40例,正常对照者(对照组)42例,于前庭窗前区置ROI行骨密度CT值的测量,同时对耳硬化患者行气骨导差听力测量及语频气导。将两组样本正常耳及硬化耳骨密度平均CT值记录,将结果进行t检验,对耳硬化患者听力水平及CT值相关系数进行Pearson分析,CT诊断耳硬化的功效应用ROC曲线分析。结果对照组前庭前区CT值在1797.72-2675.78HU之间,平均(2168±22.64)HU,实验组前庭前区CT值在457.82-2273.34HU之间,平均(1368.23±75.43)HU,将两组平均CT值进行对比,对照组明显高于实验组(P<0.01);实验组平均CT值与气骨导差(r=0.02,P=0.90)、与语频气导阈值(r=0.17,P=0.16)间均无明显差异。应用平均CT值诊断的敏感度为82.2%,鉴别耳硬化的ROC曲线面积为0.85(P<0.05),诊断阈值为1927.16HU,特异性为91.3%。结论在耳硬化症的诊断中,骨密度测量效果明显,但于听力评估方面上并不理想。

Objective To discuss the diagnosis of otosclerosis, a high-resolution CT（HRCT） BMD measurement of use value. Methods April 2011 to March 2012 in our hospital patients with otosclerosis（experimental group） 40 cases of normal controls（control group） 42 cases, the window area is set in the vestibular bone density CT value ROI The the measure, while patients with otosclerosis air-bone gap measure hearing and speech frequency air conduction. The two samples of normal ear and ear bone sclerosis average CT value recording, the t-test results for otosclerosis patient hearing level and CT value Pearson correlation coefficient analysis, CT diagnosis of otosclerosis efficacy using ROC curve analysis. Results CT Pretrial area between the control group 1797.72-2675.78 HU, average（2168±22.64） HU, the experimental group Pretrial district CT values between 457.82-2273.34 HU, average（1368.23±75.43） HU, the two The mean CT values were compared, the control group was significantly higher than those in the experimental group（P〈0.01）; the experimental group, the average CT value of air-bone gap（r=-0.01, P=0.93）, and the speech frequency air conduction threshold（r=0.17, P=0.18） were not significantly different between. CT diagnosis using an average value of the sensitivity of 82.2%, ROC curve otosclerosis to identify an area of 0.85（P〈0.05）, the diagnostic threshold 1927.16 HU, specificity was 91.3%. Conclusion The diagnosis of otosclerosis, the bone density measurement effect is obvious, but on hearing assessment is not ideal.