高分辨率CT显示听小骨能力的研究

目的 探讨高分辨率CT（HRCT）单侧密集骨重建技术对听小骨细微结构的显示能力及对疾病的诊断价值。方法：收集45人，81只耳的资料，全部病例行HRCT扫描，后进行单侧局部密集骨重建，观察轴冠位的正常及异常HRCT图像对听小骨（包括砧骨豆状突，砧镫关节，镫骨前后脚、脚板）的显示情况。结果：慢性中耳乳突炎31只，外耳道先天性闭锁伴中耳发育畸形2只，颞骨骨折波及中耳1只。HRCT密集骨重建，轴冠位结合扫描，能清晰显示听小骨炎症的微小破坏，骨折等病变；结合中耳仿真内镜可清晰地显示发育畸形的听小骨。结论：HRCT能清晰，准确地显示听小骨细微结构。优于传统的CT图像，可为临床诊断和治疗提供可靠的依据。

High resolution CT of auditory ossicles

Objective:To evaluate the ability and clinical value of HRCT with unilateral overlapping bone reformation in visulization of auditory ossicles and ossicular diseases.Methods:HRCT was performed in 81 ears of 45 cases,and then unilaterally reconstructed with a bone algorithm.Additional axial and coronal scanning was used to evaluate the visualization of normal and abnormal ossicles, including the process of the incus,the incudostapedial joint,the anterior and posterior crura,and footplate of stapes.Results:There were 31 ears of chronic otitis media,2 ears atresia of external auditory meatus complicated with congenital abnormalities of the middle ear,1 ear temporal bone fracture involving the middle ear.HRCT,together with axial and coronal scanning,could make detailed demonstration of small destruction of ossicles and fracture of temporal bone. Combined with CTVE, HRCT clearly documented ossicle dysplasia. Conclusion: HRCT can clearly and accurately make detailed demonstration of fine structure of auditory ossicles,it is superior to conventional CT, and warrant clinical diagnosis and treatment planning.