听骨链CT仿真内窥镜的临床应用

目的　探讨听骨链CT仿真内窥镜 (CTVE)的临床应用价值及其限度。方法　使用准直 1 0mm、螺距 1 0扫描 ,骨算法、视野 9 6cm、间隔 0 1- 0 2mm重建对 4 0例临床怀疑中耳病变(30例手术 )的患者进行CTVE成像 ,并与轴位高分辨率CT(HRCT)、多平面重组 (MPR)图像及手术结果进行对照分析。结果　CTVE诊断听小骨破坏的准确性为 92 6% ,明显高于轴位HRCT(84 % )和MPR(77% )图像。CTVE也能清楚地显示听骨链发育异常和术后的状况。结论　CTVE能显示听骨链的立体影像 ,有利于听骨链病变的显示和诊断。但CTVE不能清楚地显示鼓室腔内异常软组织、鼓膜和鼓室骨壁的异常改变 ,且结果易受人为因素影响。

CT virtual endoscopy of the auditory ossicular chain: clinical applications

To evaluate the clinical applications and limitations of CT virtual endoscopy (CTVE) in the auditory ossicular chain Methods CTVE of the auditory ossicular chain was performed with 1 0?mm collimation at pitch 1 0, bone algorithm, 9 6?cm field of view, and 0 1-0 2?mm reconstruction interval in 40 patients with middle ear diseases 30 cases were confirmed by surgery Results were compared with the findings of axial high resolution CT (HRCT) and multiplanar reformation (MPR) images and surgery Results The accuracy of CTVE images in detecting ossicular destruction was 92 6%, significantly higher than that of axial HRCT (83 9%) and multiplanar reformation (76 5%) images CTVE could also clearly reveal the postoperative condition and congenital dysplasia of the auditory ossicular chain Conclusions CTVE can clearly demonstrate a three dimensional image of the auditory ossicular chain and is useful in evaluating diseases of the ear, especially the auditory ossicles CTVE could not clearly demonstrate abnormal soft tissue within the tympanic cavity, abnormal changes of the tympanic membrane and tympanic walls, and could be easily influenced by artificial factors