多层螺旋CT后处理技术对人工听骨链重建术前听骨链完整性的诊断价值分析

目的研究多层螺旋CT(MSCT)后处理技术对中耳炎患者人工听骨链重建术前听骨链完整性的诊断价值。方法选取2015年10月至2018年10月我院人工听骨链重建术前行MSCT检查的慢性或胆脂瘤中耳炎患者74例临床资料进行回顾性分析,所有患者均完成MSCT检查和手术治疗,将扫描数据进行多平面重组(MPR)、仿真内窥镜(VE)及容积重现(VR)等重建处理,并以手术结果为金标准分析三种处理技术对听骨链各部位完整性的术前诊断价值。结果 MPR、VE及VR对锤骨和砧骨畸形诊断准确性大致相近,均显示出良好准确性,其中VR对锤骨颈准确率优于MPR,对锤骨头准确率优于VE;同时MPR对砧镫关节和镫上畸形诊断效果较VE和VR具有一定优势。结论MPR、VE及VR均为常用MSCT后期处理技术,用于慢性中耳炎患者听骨链术前完整性评估均具有良好价值,在常规图像基础上结合多种后期处理技术可提升诊断准确率。

The Diagnostic Value of Multi-slice Spiral CT(MSCT) Post-treatment Technique for the Integrity of Ossicular Chain before the Reconstruction of Artificial Ossicular Chain

Objective To study the diagnostic value of multi-slice spiral CT(MSCT) post-processing technique on ossicular chain integrity before artificial ossicular chain reconstruction in patients with otitis media. Methods A retrospective analysis was performed on clinical data of 74 patients with chronic or cholesteatoma otitis media who underwent MSCT examination before artificial ossicular chain reconstruction in our hospital from October 2015 to October 2018. All patients were given MSCT examination and surgical treatment. The scan data were reconstructed by multi-planar recombination(MPR), virtual endoscopy(VE) and volume rendering(VR), and the surgical results were used as the gold standards to analyze the preoperative diagnosis value of the three processing methods on integrity of various parts of ossicular chain. Results MPR, VE and VR had similar diagnostic accuracy for malleus and incus malformations, and all show good accuracy, and the accuracy rate of neck of malleus by VR was better than that by MPR, and the accuracy rate of head of malleus was better than that by VE. The diagnostic effects of incudostapedial joint and stapes malformations by MPR were more advantageous over VE and VR. Conclusion MPR, VE and VR are commonly used MSCT postprocessing techniques. And they are of good value for the preoperative integrity evaluation of ossicular chain in patients with chronic otitis media. Combining various post-processing techniques on the basis of conventional images can improve the diagnostic accuracy rate.