高分辨率CT联合多平面重组及曲面重组诊断外伤性听力损伤病因

High resolution CT combined with multiplanar reformation and curved planar reformation for etiological diagnosis of traumatic hearing injuries

目的探讨高分辨率CT(HRCT)多平面重组(MPR)及曲面重组(CPR)技术诊断外伤性听力损伤病因的价值。方法对104例经手术证实外伤性听骨链异常致听力损伤患者(共109耳)采集颞骨HRCT,并以MPR显示听骨、CPR显示听骨链,观察听骨链损伤表现。结果HRCT结合MPR及CPR对锤砧及砧镫关节脱位、半脱位和听骨骨折的检出率均为100%。109耳中,53耳(53/109,48.62%)存在锤砧关节脱位(44耳)或半脱位(9耳),24耳存在(24/109,22.02%)砧镫关节脱位(20耳)或半脱位(4耳);其中29耳(29/109,26.61%)同时存在锤砧及砧镫关节脱位;1耳(1/109,0.92%)锤骨颈骨折合并锤砧关节半脱位,1耳(1/109,0.92%)砧骨短突骨折合并锤砧关节脱位,1耳(1/109,0.92%)镫骨骨折。结论HRCT结合MPR显示听骨及CPR显示听骨链可有效诊断外伤性听骨链损伤,为明确外伤性听力下降病因提供影像学依据。

Objective To investigate the value of high resolution CT(HRCT)combined with multiplanar reformation(MPR)and curved planar reformation(CPR)for etiological diagnosis of traumatic hearing injuries.Methods Temporal bone HRCT of 109 ears in 104 patients(99 cases with unilateral ear and 5 cases with bilateral ears)with hearing loss caused by traumatic ossicular chain injuries confirmed by surgery were collected,then MPR of ossicular bones and CPR of ossicular chain were performed to observe the manifestations of ossicular chain injuries.Results The detection rate of HRCT combining with MPR and CPR for hammer-anvil and incus-stapes joint dislocation,subluxation and ossicular fracture was all 100%.Among 109 ears,dislocated(44 ears)or subluxated(9 ears)hammer-anvil joint were found in 53 ears(53/109,48.62%),dislocation(20 ears)or subluxation(4 ears)of incus-stapes joint were detected in 24 ears(24/109,22.02%),while dislocation of hammer-anvil and anvil-stapes joints co-existed in 29 ears(29/109,26.61%).Malleus neck fracture combined with malleus anvil joint subluxation,incus short process fracture with malleus anvil joint dislocation,also stapes bone fracture was observed in 1 ear(1/109,0.92%),respectively.Conclusion HRCT combined with MPR of ossicular bones and CPR of ossicular chain could effectively diagnose traumatic ossicular chain injuries and provide imaging references for etiology of traumatic hearing loss.