HRCT在胆脂瘤型中耳炎听骨链破坏诊断中的价值

Evaluation of Ossicular Chain Destruction in Cholesteatomatous Otitis Media Based on HRCT

目的 利用颞骨薄层HRCT多平面重组(MPR)及曲面重组(CPR)技术评价胆脂瘤型中耳炎患者听骨链(OC)破坏情况。方法将34例37耳经手术病理证实为胆脂瘤型中耳炎患者的颞骨HRCT轴位、MPR及CPR图像对听骨链破坏的显示情况与术中所见进行对照,评价各方法的灵敏性与特异性。结果MPR重建图像显示锤骨破坏的敏感性及特异性均为100%,MPR重建及CPR重组显示砧骨破坏的敏感性分别为97.1%及91.2%,特异性均为100%,MPR重建及CPR重组显示镫骨破坏的敏感性及特异性均为88.9%及84.2%,MPR重建对锤砧关节骨质破坏显示的敏感性及特异性均为100%,CPR重组对砧镫关节骨质破坏显示的敏感性及特异性均为100%。结论HRCT MPR及CPR技术可以准确评估胆脂瘤型中耳炎患者听骨链破坏的情况,为外科手术的可行性提供可靠的影像学参考数据。

Objecttive To estimate the development of ossicular chain(OC) in patients with cholesteatomatous otitis media by multiplanar reformation(MPR) and Curved Planar Reformation(CPR) of HRCT.Methods To evaluate the sensitivity and specificity of CT axial,MPR,and CPR images in displaying ossicular chain destruction in 34 patients with 37 ears of cholesteatomatous otitis media confirmed by surgery and pathology,and to compare them with intraoperative results.Results The sensitivity and specificity of MPR for malleus bone destruction were 100%,while the sensitivity and specificity of MPR and CPR for incus bone destruction were 97.1% and 91.2%,respectively,and both were 100%.The sensitivity and specificity of MPR and CPR for stapes bone destruction were 88.9% and 84.2%.The sensitivity and specificity of MPR for malleus and incus joint bone destruction were 100%,and the sensitivity and specificity of CPR for incus and stapes joint bone destruction were 100%.Conclusion The MPR and CPR of Temporal Bone HRCT can provide reliable imaging reference data for the feasibility of surgery by estimating the development of OC in patients with cholesteatomatous otitis media.