256层HRCT及重建技术在听骨链损伤术前评估中的应用

目的 探讨256层高分辨率CT(HRCT)及重建技术在听骨链损伤术前评估中的临床应用价值.方法 对106例颞骨外伤患者进行256层HRCT轴位扫描,收集其中听骨链损伤患者38例.用Philips工作站,行颞骨多平面重建(MPR)、听骨链的曲面重建(CPR)、3D容积再现(3D VR)观察分析听骨链损伤位置、类型及其相邻结构受累的情况,并进行随访.计算原始轴位(AX)、MPR、CPR、3D VR的显示率.结果 106例颞骨外伤患者中,38例(76耳)听骨链损伤,听小骨脱位43耳,其中锤砧关节脱位22耳,锤砧并砧镫关节脱位6耳,砧镫关节脱位3耳,听小骨转位11耳,镫骨前庭脱位1耳;听小骨骨折4耳,其中锤骨骨折2耳,砧骨骨折1耳,镫骨骨折1耳.38例听骨链损伤患者中11例行手术治疗,术后结果与影像诊断结果一致.AX、MPR、CPR、3D VR的显示率分别为97.87％、100％、97.87％、82.98％.结论 256层HRCT及重建技术能清晰显示听骨链损伤的情况,是术前评估的可靠方法.

Application value of 256-slice high resolution CT and reconstruction technique in the preoperative assessment of ossicular chain trauma

Objective To explore the application value of 256-slice high resolution CT(HRCT)and reconstuction technique in the preoperative assessment of ossicular chain trauma.Methods 106 cases of temporal bone trauma were scanned using 256-slice HRCT,38 cases of ossicular chain trauma were collected.The multi-planar reformaition(MPR),curved plannar reformation(CPR) and three-dimensional volume rendering reformation (3D VR)of the ossicular chain were performed on Philips work station.The locations, types and the involving structures were analyzed,then these cases were followed up.The display rates of AX,MPR,CPR,3D VR were evaluated.Results Among 106 cases of temporal bone trauma,38 cases(76 ears)were found ossicular chain trauma,in which there were 43 ears of ossicular dislocation,22 ears incudomalleolar joint separation,6 ears incudomalleolar and incudostapedial joint separation,3 ears incudostapedial joint separation,11 ears translocation of the ossicles,1 ear stapediovestibular dislocation;4 ears ossicular fractures,2 ears fracture of the malleus,1 ear fracture of the incus,1 ear fracture of the stapes.Among 38 cases,11 cases underwent surgery,and the surgical results were consistent with CT findings.The display rates of AX,MPR,CPR,3D VR were 97.87％,100％, 97.87％,82.98％ respectively.Conclusion 256-slice HRCT and reconstuction technique can clearly reveal the whole structure of ossicular chain trauma,which are effective methods for diagonsis of ossicular chain trauma before surgery.