面神经管螺旋CT多平面和曲面重建成像的临床应用

目的 探讨螺旋CT多平面和曲面重建成像对面神经管显示的临床应用。方法 对1具尸体头颅标本、2个颅骨标本及43例患者进行颞骨螺旋高分辨CT扫描，层厚1．0mm、间距0．2mm、螺距为1。然后进行冠状面、矢状面及斜面的多平面重建(MPR)和面神经管全程的曲面重建成像，对尸体标本解剖面神经管，并与其断面图像对比。结果 CT图像所见与标本解剖一致，40侧正常耳的面神经管迷路段、水平段在轴面扫描图像上显示最优，面神经管垂直段在矢状面及斜面重建图像上显示最优，曲面重建能显示面神经管连续的全程。中耳乳突炎25耳中，面神经管水平段及垂直段有破坏者分别为6耳及5耳；先天性外耳道闭锁的16耳中，面神经管异常达10耳；外伤后面瘫的5耳中，3耳见有面神经管骨折。面神经管在螺旋CT多平面和曲面重建图像上的表现与临床手术所见相符。结论 螺旋CT多平面和曲面重建成像技术有利于面神经管的显示及其病变的诊断。

Clinical application of multiplanar and curved reformatted images of spiral CT in facial nerve canal

Objective To assess the clinical application of multiplanar and curved reformatted images of spiral CT in facial nerve canal.Methods Spiral CT with multiplanar reformation (MPR) and curved reformation were performed in 2 dry skulls,1 cadaveric head,and 43 patients.The cadaveric head was dissected and compared with the corresponding tomographic slices. Results Spiral CT with multiplanar and curved reformatted images could clearly show the facial nerve canal of all ears.The facial nerve canal of the cadaveric head showed on spiral CT was in good accordance with that seen in the dissection.Chronic otitis media with cholesteatoma demonstrated destruction of facial nerve canal.Among 16 ears with the congenital abnormities,facial nerve canal dysplasia was seen in 10 ears.The fracture of facial nerve canal was displayed in 3 injured ears. Conclusion Spiral CT with MPR and curved reformation is a useful technique for the evaluation of facial nerve canal of ear.The usage of the technique as a clinical routine is recommended.