多层螺旋CT三维成像对慢性中耳乳突炎的诊断价值研究

目的探讨多层螺旋CT（muhislicespiralCT，MSCT）三维重建对慢性中耳乳突炎患者中耳、乳突精细结构破坏的诊断价值。方法应用128层螺旋CT扫描机，对68例慢性中耳乳突炎患者行颞骨薄层扫描及透明化容积重建fvolumereconstruction，VR）、多平面重组（multipleplanereconstruction，MPR），正常对照耳观察听骨链的形态结构；病变耳观察中耳乳突结构的改变及骨质破坏情况并与手术结果进行比较。结果正常组VR、MPR对锤骨、砧骨及锤砧关节均能清晰显示，MPR对镫骨及镫砧关节能部分显示。病变组76耳中耳乳突破坏MSCT诊断与手术病理结果基本一致。结论MSCT三维重建可清晰显示中耳的精细结构，对中耳乳突炎骨质破坏诊断准确，对镫骨、镫砧关节及其骨质破坏显示欠佳。

Value of MSCT three-dimensional imaging in diagnosis of chronic otimastoiditis

Objective To study the value of MSCT 3-dimensional imaging in reconstruction of middle ear and in diagnosis of chronic otimastoiditis. Methods Sixty-eight patients with chronic otimastoiditis underwent 128-layer spiral CT scanning and transparent volume reconstruction （VR） and multiple plane reconstruction （MPR） to observe the morphology of ear ossicles in normal control group and the bone structure destruction of middle ear and mastoid in lesion group. The outcomes in the two groups were compared after operation. Results MSCT 3-dimensional imaging could show the functions of malleus, incus and hammer anvil joints after VR and MPR, and the partial functions of stapes and stirrup anvil joints after MPR in normal control group. The diagnosis of middle ear and mastoid bone destruction established by MSCT 3-dimensional imaging was basically consistent with that established by surgical pathology in 76 ears of lesion group. Conclusion MSCT 3-dimensional imaging can clearly show the fine structure of middle ear and accurately diagnose the middle ear and mastoid bone destruction, but cannot clearly show the functions of stapes, stirrup anvil joints and their bone destruction.