基于高分辨率CT的成人颞骨气化评估方法学研究

Study on method for assessment of temporal bone pneumatization in adults with high-resolution CT scanning

目的基于高分辨率CT(HRCT)单一典型层面上的骨性参考结构,创建颞骨气化程度的评估方法。方法回顾性分析221例(442耳)受检者颞骨HRCT图像,行三维重建技术获得颞骨气化容积,行横断面图像标准化重组。在横断面锤砧关节复合体显示最佳层面,分别以中颅窝外壁、乙状窦沟、骨迷路为参考结构,将颞骨气化程度分为0分、1分、2分。结果分别以颅中窝外壁、骨迷路为参考结构进行评分,各组间颞骨气化容积均有显著性差异。以乙状窦沟为参考结构,0分组4耳,0分、1分组与2分组间颞骨气化容积有显著性差异(P<0.05)。各组间评分与颞骨气化容积均呈正相关(r前=0.519,r后=0.479,r内=0.488);综合各参考结构评分,0分组3耳,合并入1分组,组间两两比较,组间差异均有统计学意义(P<0.05);组间评分与颞骨气化容积正相关(r=0.663)。结论颅中窝外壁、骨迷路、乙状窦沟均可作为HRCT上反映颞骨气化程度的参考结构,联合三者评分可更准确地反映颞骨气化程度。

Objectives To establish the method for assessment of entire temporal bone pneumatization（ TBP） on single typical level for osseous labyrinth referential structure by high-resolution computed tomography（ HRCT）. Methods The images of HRCT in 221 individuals（ 442 ears） were retrospectively reviewed and analyzed. The volume of TBP was measured by three-dimensional reconstruction. The standard axial images were reformatted. At the level of the malleoincudal complex,the ears with different degree of aeration were divided into 0 point group,1 point group or 2 points group by using the outer wall of middle cranial fossa,sigmoid sulcus and osseous labyrinth as referential structures respectively. Results Statistically significant difference existed among the contiguous groups based on the outer wall of middle cranial fossa and osseous labyrinth,respectively. When the sigmoid sulcus was used as the referential structure,there were only four ears with 0 point,and statistically significant difference existed between 1 point group and 2 points group. There was a base on each referential structure（ ranterior = 0. 519,rposterior= 0. 479,rmedial = 0. 488）. After combination of points based on selected referential structures,there were still three ears with 0 point. Significantly statistical difference existed between any two groups. Positive correlation existed between groups and volume of TBP（ r = 0. 663）. Conclusion The outer wall of middle cranial fossa,sigmoid sulcus and osseous labyrinth may be used as referential structures to reflect the degree of TBP. Moreover,combination of all these three referential structures may raise the accuracy for reflecting the degree of TBP.