正常中耳64排螺旋CT仿真内窥镜和听骨链三维重建

目的:探讨64排螺旋CT仿真内窥镜(CTVE)和听骨链表面遮盖法(SSD)成像对正常中耳结构的显示情况及其技术方法。方法:无临床症状、临床检查未见异常、CT显示正常者35耳,行中耳CTVE及听骨链SSD成像,重建图与正常图谱、二维CT图对照。结果:CTVE100%(35/35)清晰显示大部分听骨链的结构及鼓室各壁结构;CTVE对镫骨前后脚的显示率分别为68.6%(24/35)和74.3%(26/35),CTVE尤其清晰显示后鼓室重要结构;听骨链SSD成像100%(35/35)清晰显示听小骨各结构,尤其是完全显示了镫骨前后脚及脚板。结论:64排螺旋CT的CTVE及听骨链SSD成像,能够建立正常中耳立体解剖结构模式,立体、清晰地显示正常中耳腔内部及各壁重要的解剖结构,为临床对中耳三维结构的观察提供更直接的影像学资料,该技术方法简单、快速,值得推广。

Virtual endoscopy of the normal middle ear and SSD of ossicular chain on 64-detector computed tomography

Objective:To assess the values of virtual endoscopy(VE) of normal middle ear and shaded surface display (SSD) of ossicular chain on 64-detector CT. Methods: Spiral CT scan of the temporal bone was performed with 0.5mm slice thickness at pitch 1.0, 0.2 -0.3 mm reconstruction interval in 33 patients (35 normal ears). CTVE, SSD of middle ear were performed. Results:On CTVE imaging, the visualization rate of most structures of ossicular chain and tympanic wall were 100% , and were 68.6%(24/35)and 74.3%(26/35)for the anterior and posterior crus of stapes. CTVE clearly displayed the structures of retrotympanum. SSD showed structures of ossicles in 100%(35/35), especially the anterior and posterior crus and base of stapes. Conclusions:CTVE and SSD could clearly exhibit three-dimensional images of the normal middle ear, and build a normal anatomic mode. It is simple and easy method for image diagnostics.