256排CT扫描鼓室盾板在胆脂瘤型中耳炎诊断中的价值

The Value of 256-Slice CT Scan of Tympanum Shield in the Diagnosis of Middle Ear Cholesteatoma

目的探讨鼓室盾板在256排CT的形态特征在胆脂瘤型中耳炎诊断中的价值。方法选取2017年3月—2021年3月山东省荣成市人民医院80例临床诊断为慢性化脓性中耳炎患者行CT扫描,对获得的数据进行多平面重建(multiplanar reconstruction,MPR),冠状位观察鼓室盾板的形态,作出有无并发胆脂瘤的诊断,与术中所见和术后病理诊断对照,评价其符合率。结果56例患者鼓室盾板有明显骨质破坏吸收,其中54例患者手术证实合并胆脂瘤。24例患者鼓室盾板无明显骨质破坏吸收,14例患者为骨疡型,10例为单纯型。胆脂瘤型中耳炎与鼓室盾板破坏的CT表现符合率为94.2%。结论256排CT扫描鼓室盾板在胆脂瘤型中耳炎的诊断中有较高的诊断价值,鼓室盾板的骨质破坏是诊断胆脂瘤型中耳炎较特异性的指标,为临床对中耳炎的分型及选择手术方式的选择、术后随访提供了很大帮助。

Objective To explore the value of 256-slice CT findings of tympanum shield in the diagnosis of middle ear cholesteatoma.Methods CT scan was performed in 80 patients with chronic suppurative otitis media from March 2017 to March 2021 of People's Hospital of Rongcheng,Shandong Province,multiplanar reconstruction was performed on the acquired data,the shape of tympanum shield plate was observed in coronal position to decide wether there was cholesteatoma.The coincidence rate was caculated by comparing CT imaging diagnosis with intraopertive findings and postoperative pathological results.Results A total of 56 cases had obvious bone destruction or absorption in the shield plate of tympanum,forty-four of them were proved to be combined with cholesteatoma.There was no obvious bone destruction and absorption in the shield plate of tympanum in 24 patients.Among them,granulomatous otitis media was proved in 14 patients,simple otitis media in 10 patients.The coincidence rate between 256-slice CT findings of tympanum shield destruction and clinical diagnosis in middle ear cholesteatoma was 94.2%.Conclusion Two hundred fifty-six-slice CT scan fingdings of tympanum shield has a high value in the diagnosis of middle ear cholesteatoma.The destruction of tympanum shield is a high specific index in the diagnosis of middle ear cholesteatoma.It provides a great help for the classification of chronic suppurative otitis media,the selection of operation mode and the follow-up after operation.