人工耳蜗植入术后锥体束CT影像评估

目的利用锥体束CT及多种后处理重建技术显示植入耳蜗电极位置、深度、计数植入电极数及测量离蜗轴距离，并对植入电极清晰度进行评价，探讨锥体束CT对人工耳蜗植入术(cochlear implantation, CI)后植入电极影像评估的应用价值。方法收集行CI手术患者35例，所有患者在术后行植入侧锥体束CT扫描，仪器为（VATECH）PaX Uni3D高分辨锥体束CT，管电压为：89 KV，管电流为：4.0 mA；并分别做垂直及平行于蜗轴轴位的冠状及斜矢状位的MPR图像和三维图像；计数植入电极数、测量电极深度、离蜗轴距离、评估电极位置，并进行电极清晰度的评价。结果锥体束CT可清晰显示耳蜗内电极矩阵走行，可测量电极植入深度和计数电极个数；测得植入电极共766颗，平均（21.88±2.17）颗；测定电极植入深度的平均值（19.37±1.96）mm，对比术中实际测定深度平均值（19.31±2.03）mm，两组数据差异无统计学意义（P＞0.05）。两位医生对电极清晰度的评价一致性良好（t=-0.502，P=0.619）。结论锥体束CT能显示植入电极位置、深度、计数植入电极数及测量离蜗轴的距离，可应用于临床CI术后对耳蜗内植入电极的评估。

Cone beam computerized tomography imaging evaluation after cochlear implantation

ObjectiveTo explore the application value of cone beam computerized tomography (CBCT) in postoperative imaging evaluation of intracochlear electrodes after cochlear implantation (CI) via analyzing detailed data such as insertion localization, depth, electrode number and visualization of the electrode array, obtained by CBCT and postprocessing techniques.Methods35 patients receiving CI in our hospital were included. Postoperative CBCT was performed to all the patients. Images were acquired from (VATECH) PaX Uni3D high resolution CBCT with the tube voltage of 89 KV and the tube current of 4.0mA. The coronal and oblique sagittal multi planar reconstruction (MPR) images vertical and parallel to the cochlear axis and 3 dimensional images were reconstructed. The electrode number was counted, the depth of the electrode as well as its distance to the cochlear axis were measured, the position and definition of the electrode were evaluated.ResultsCBCT could clearly display the intracochlear electrode array with measuring the depth of electrode implanted and counting the number of electrodes. 766 implanted electrodes were detected in all the 35 patients, with an average of 21.88±2.17. The mean depth value of implanted electrode detected by CBCT was (19.37±1.96) mm, while that measured during operation was (19.31±2.03) mm, and their difference was statistically insignificant (P>0.05). Two doctors had good consistency in the evaluation of electrode definition (t=-0.502,P=0.619>0.05).ConclusionCBCT can display the location and depth of the implanted electrodes, count the number of implanted electrodes and measure the distance between the electrode and cochlear axis, therefore can be applied to the evaluation of the implanted electrodes after CI.