高分辨率CT多平面重组对迷路瘘管的诊断价值

目的:探讨高分辨率CT(HRCT)多平面重组对半规管的显示能力及对慢性化脓性中耳炎并发迷路瘘管的诊断价值。方法:对86例(正常79耳,病变93耳)慢性化脓性中耳炎患者行HRCT扫描,正常耳行轴位、冠状位及各半规管多平面重组(s-MPR)图像整体显示半规管的形态和结构情况;病变耳观察各半规管的破坏情况,并与手术结果比较。结果:正常耳轴位仅部分能显示外半规管全程(仅显示外半规管68耳),冠状位各个半规管全程均不能完整显示,s-MPR可分别在同一层面上显示各半规管全程(上半规管73耳,外半规管79耳,后半规管77耳)。病变耳轴位显示外半规管瘘5耳,冠状位显示外半规管瘘4耳,两者均显示1耳上半规管瘘;s-MPR显示外半规管瘘6耳,上半规管瘘2耳。手术探查见外半规管破坏6耳,上半规管破坏2耳。结论:s-MPR可以完整显示各半规管全程,对迷路瘘管具有较高的诊断价值。

The diagnostic value of labyrinthine fistula with multi-planar reconstruction in chronic otitis media by HRCT

Objective:To study the ability of HRCT to delineate the semicircular canals and the diagnostic va-lue of HRCT in identifying labyrinthine fistula in chronic otitis media(COM) by means of multiplanar reconstruction.Method:Eighty-six patients(79 healthy ear and 93 ailed ears) with chronic otitis media were scanned with HRCT,and the original data was processed with MPR.In the nomal ears the semicircular canals form were individually observed and the canal geometry were compared in axial and coronal and s-MPR.In COM the destruction of the canal were observed and compared with the intraoperative findings.Result:The full length of horizontal semicircular canal can be displayed in some cases and the full length of the three canals can’t be displayed in any single coronal image but they can be individually displayed in one image in s-MPR.In the COM,six ears labyrinthine fistula were found in the axial and five ears in coronal images;six ears were located at the horizontal semicircular canal and two ears at the superior semicircular canal in the s-MPR,which corresponeded with the intraoperative findings.Conclusion:s-MPR can display the full path of individual semicircular canal in one image and is promising in identifying labyrinthine fistula.