颞骨高分辨率CT在55例中耳疾病中的临床应用

目的探讨颞骨高分辨率CT在慢性化脓性中耳炎、中耳畸形及颞骨骨折中的应用价值。方法采集层厚0.5 mm,螺距15,轴状位薄层扫描,骨算法,FOV 9.6 cm、间隔1 mm重建。对44例(耳)慢性化脓性中耳炎,9例(耳)中耳畸形病人进行骨最大密度投影(MIP)及听小骨三维重建(SSD)成像,对2例颞骨骨折致面瘫病人行颞骨矢状斜位成像显示面神经。分别将55例病人的CT图像术中所见对比,分析颞骨、外耳道、中耳(鼓室、鼓窦、乳突、听小骨、面神经、天盖、盾板等)、内耳(骨半规管、耳蜗及前庭)的特征及存在的解剖变异。结果高分辨率CT清晰地显示了耳部微小病灶,明确了病变范围与周围结构的关系,听小骨的SSD对锤骨、砧骨、镫骨、锤砧关节、砧镫关节的显示有着极高的逼真性,颞骨矢状斜位极好地显示了面神经的破坏部位,为临床制定手术方案提供了有力的影像学依据。结论颞骨高分辨率CT对中耳炎症、畸形、颞骨骨折致面瘫的诊断和手术方案的制定有重要的临床价值。颞骨高分辨率CT可列为中耳疾病的常规检查项目。

Clinical application of high resolution CT in diagnosis and treatment of middle ear diseases

Objective To discuss the clinical value of the temporal bone high resolution CT(HRCT) on chronic suppurative otitis media,middle ear abnormality,and temporal bone fracture.Methods During the scanning process,layer thickness(0.5 mm),pitch 15,axle-form place lamellar scanning,bone-algorithm,FOV(9.6 cm) and interval 1 mm reconstruction were adopted.The CT images of the 55 patients were compared with what were found during the surgery,and the anatomic characteristics and variations of the temporal bone,the external ear,the middle ear and the inner ear were analyzed.Results HRCT could show the tiny indisposition of the ear clearly,and pinpoint the relationship between the range of the pathological change and the adjacent structure.The SSD of ossicles showed the malleus,incus,stapes,malleoincudial joint,and incuostapedial joint clearly.Conclusion HRCT of the temporal bone has great clinical value on the diagnosis and the operative management of middle ear diseases and the temporal bone,and therefore should be routinely taken.