先天性外中耳畸形的螺旋CT与手术对照观察

目的进一步提高螺旋CT及后处理技术诊断外中耳畸形的水平。资料与方法对22例(24耳)经手术治疗的先天性外中耳畸形病例,术前采用螺旋CT高分辨扫描,将原始扫描数据密集重组后进行多平面重组(MPR)(轴面、冠状面、斜轴面、斜冠状面)、曲面重组(CPR)及仿真内镜容积重组(VR)成像,与手术所见进行详细对照观察。结果手术治疗24耳,外耳道狭窄1耳,骨性闭锁18耳,膜性闭锁3耳。鼓室腔狭小12耳。锤骨畸形或缺如23耳,其中1耳CT见细小锤骨,而手术为缺如。砧骨缺如4耳,砧骨畸形16耳,其中有2耳手术见砧骨长脚长、砧骨粗大,而CT表现基本正常。镫骨细小畸形6耳,其他畸形7耳,镫骨缺如5耳;砧锤关节融合畸形14耳,轻度变形1耳,缺如4耳;砧镫关节融合1耳,不连5耳,缺如7耳;卵圆窗骨性封闭8耳,上述CT所见均与手术相符。手术见3耳圆窗骨性封闭,其中1耳CT表现正常。手术有3耳未见咽鼓管开口,其中1耳CT表现正常。手术见面神经管前位8耳,其中1耳CT表现正常。结论螺旋CT高分辨扫描及其多种后处理成像综合观察,多数可以反映外中耳畸形情况,有利于指导手术方案的制定。

The Comparative Study of Spiral CT and Operation in Congenital Malformation of the External and Middle Ear

Objective To improve the level of CT and reconstruction technique in diagnosis of congenital malformations in the external and middle ear. Materials and Methods 22 cases (24 ears) of deformity in the external and middle ear were performed with high differentiate scan in dual slice spiral CT and all the data were reconstructed by multiplanar reformation (MPR),curved multiplanar reformation(cMPR) and volume reconstruction (VR).The comparion of CT findings and operation was made in details. Results In 24 ears,...