螺旋CT三维重建在先天性耳部畸形诊断中的应用

目的:分析各种先天性耳部畸形的螺旋CT三维重建最佳重建平面的选择。方法:通过对40例48耳先天性耳部畸形患者行螺旋CT容积扫描,多平面重建观察其各种畸形情况。结果:横轴面诊断鼓室窦过深4耳、外耳道闭锁42耳、外耳道狭窄4耳、颈内动脉异位2耳;冠状面诊断面神经水平段低位26耳、颅中窝低位6耳、颞下颌窝及髁突畸形22耳;前斜冠状面观察测量闭锁板24耳、诊断卵圆窗缺如4耳;后斜冠状面诊断下颌窝及髁突高位6耳;矢状面诊断颈静脉球高位12耳;内斜矢状面观察面神经裸露走行于鼓室内24耳、锤砧关节融合12耳及锤骨发育不良30耳。结论:先天性耳部畸形种类多,诊断时需要多方位观察、有针对性调整特定的重建平面,以避免漏诊、误诊的发生。

Clinical application of three-dimensional reconstruction with multi-slice spiral CT in diagnosing congenital ear deformities

Objective:To analyze and obtain the best reconstruction plane of diverse congenital ear deformities on CT image.Methods:40 patients with 48 congenital deformed ears were examined with MSCT and performed with MPR reconstruction.Results:4 ears with large sinus tympani,42 ears with external aural atresia,4 ears with external auditory canal stenosis,2 ears with ectopic internal carotid artery were diagnosed on transverse plane.26 ears with low horizontal segment of the facial nerve,6 ears with middle cranial fossainferior dislocation,22 ears with condglar process and mandibular fossa malformation were diagnosed on coronal plane.Bony atretic plate of 24 ears were measured and 4 ears with oval window absence were diagnosed on anterior oblique coronal plane.6 ears with high condglar process and mandibular fossa were diagnosed on posterior oblique coronal plane.12 ears with highriding jugular bulb were diagnosed on saggital plane.24 ears with dehiscent facial nerve,12 ears with fused malleoincudal articulation,30 ears with malleus dysplasia were diagnosed on interior oblique saggital plane.Conclusion:Congenital ear deformities has many kinds.Those must be observed on different and targeted planes in order to avoid missed diagnosis and misdiagnosis.