人工耳蜗植入术后影像学评估方法研究

The Study of Three radiologic Evaluation Methods after Cochlear Implantation

目的 分别采取不同的影像学方法、技术,对人工耳蜗植入术后电极植入情况,以及内耳精细结构可能造成的损伤进行评估。方法 选取103例人工耳蜗植入手术患者,术后应用X线数字减影摄片、颞骨高分辨率CT、以及锥体束CT(CBCT)方法,以及与之相应的重建技术,对于电极植入耳蜗内达到的位置、植入电极的数量、植入角度和深度以及对耳蜗内细微结构可能的影响进行评估,并比较各种方法之间的优缺点。结果 有关植入电极在耳蜗内位置的显示,不同检测方法的有着各自的优势和不足:DR检查比较简便,观察耳蜗植入位置比较直观,但是对于细节显示不足,螺旋CT能清晰显示植入电极的位置以及耳蜗的精细结构,但是对于单个电极显示欠清晰。采用三维重建技术后,CBCT可以精确显示植入电极的形态和植入位置,但是尚不能清楚反映耳蜗内在微细结构。结论 CBCT对于耳蜗植入电极的显示很清晰,操作相对简单,可以作为人工耳蜗术后的常规检查方法。

Objective To adopt different radiologic methods and techniques to evaluate the electrode implantation after cochlear implantation and the damage that may be caused by the structure of the inner ear.Methods 103 cases after cochlear implantation were performed X-ray digital subtraction radiography,temporal bone CT,and CBCT examination,and multi-planar reconstruction(MPR)techniques were used to show the electrodes implanted after cochlear implantation on the same standard level.The position in the cochlea,the coverage angle of the electrode and the possible influence of the electrode on the fine structure of the cochlea,and the number of implanted electrodes.Results Compare the three methods to show the position and depth of the implanted electrodes after cochlear implantation.Different detection methods under the same standard system have certain differences in the display of the position of the electrodes in the cochlea:DR examination is relatively simple,and observation of the cochlear implant position is more intuitive However,the display of details is insufficient.Spiral CT can clearly show the position of the implanted electrode and the fine structure of the cochlea,but it is not clear for a single electrode.Under CT of the temporal bone,the cochlear axis and bone spiral plate can be observed.With cochlear implantation under fine operation,the electrode has little damage to the fine structure of the cochlea.After adopting three-dimensional reconstruction technology,CBCT can.Conclusion CBCT has a clear display of cochlear implant electrodes,and the operation is relatively simple.It can be used as a routine examination method after cochlear implant surgery.