HRCT曲面重建成像在中耳乳突炎致面神经管骨质破坏中的临床应用
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摘要
目的:探讨高分辨率CT(high-resolution CT,HRCT)曲面重建成像在术前评价中耳乳突炎致面神经管骨质破坏的诊断价值。方法:回顾性对比分析经手术证实中耳乳突炎74耳,全部病例均行HRCT检查,并行曲面重建成像,重建面神经管全貌,分析面神经管的骨质破坏情况,并与手术资料进行比较。结果:曲面重建均能显示74耳中耳乳突炎患者面神经管全程。49耳慢性化脓性中耳乳突炎中,35耳面神经管全程骨质显示连续,8耳面神经管水平段破坏,6耳垂直段有破坏;25耳胆脂瘤型中耳乳突炎中,7耳面神经管全程骨质显示连续,11耳面神经管水平段破坏,4耳垂直段有破坏,3耳面神经管水平段、垂直段均有破坏。74耳面神经管在HRCT曲面重建图像上的表现与临床手术所见相符。结论:HRCT的曲面重建成像能够显示面神经管全程走行和病变部位。
Objective: To discuss the preoperative evaluation of high-resolution CT( HRCT) surface reconstruction imaging in the middle ear mastoiditis to assess the diagnostic value of facial nerve canal bony destruction.Methods: 74 ears of middle ear mastoiditis were confirmed by surgery. HRCT was done in all cases,facial nerve canal was reconstructed by curved surface reconstruction imaging,analysed the facial nerve canal bony destruction,and comparing with operation data. Results: Surface reconstruction could show 74 ears middle ear mastoiditis patients facial nerve canal. In 49 chronic suppurative mastoiditis from the middle ear,35 ears the facial nerve canal bone showed all the continuous,8 ears showed facial canal level period of destruction,6 ears vertical section had destroyed; in 25 ear cholesteatoma in middle ear mastoiditis,7 facial canal bone showed all the continuous ears,11 ears showed level of facial nerve canal section of destruction,Vertical section 4 ears had damage,facial nerve canal level and vertical section were destroyed in 3 ears. 74 ears facial canal on HRCT surface reconstruction image performance consistent with clinical surgery could see. Conclusion: HRCT surface reconstruction imaging can show facial canal take line all the way and the diagnosis of lesions.
Objective: To discuss the preoperative evaluation of high-resolution CT( HRCT) surface reconstruction imaging in the middle ear mastoiditis to assess the diagnostic value of facial nerve canal bony destruction.Methods: 74 ears of middle ear mastoiditis were confirmed by surgery. HRCT was done in all cases,facial nerve canal was reconstructed by curved surface reconstruction imaging,analysed the facial nerve canal bony destruction,and comparing with operation data. Results: Surface reconstruction could show 74 ears middle ear mastoiditis patients facial nerve canal. In 49 chronic suppurative mastoiditis from the middle ear,35 ears the facial nerve canal bone showed all the continuous,8 ears showed facial canal level period of destruction,6 ears vertical section had destroyed; in 25 ear cholesteatoma in middle ear mastoiditis,7 facial canal bone showed all the continuous ears,11 ears showed level of facial nerve canal section of destruction,Vertical section 4 ears had damage,facial nerve canal level and vertical section were destroyed in 3 ears. 74 ears facial canal on HRCT surface reconstruction image performance consistent with clinical surgery could see. Conclusion: HRCT surface reconstruction imaging can show facial canal take line all the way and the diagnosis of lesions.
引文
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[2]陈东.HRCT对中耳胆脂瘤的诊断价值及手术治疗的指导意义[J].泰山医学院学报,2011,32(9):681-683.
[3]仇继兵,谭长强.鼓室内应用甲基泼尼松龙和庆大霉素治疗自身免疫性膜迷路积水[J].东南大学学报:医学版,2012,3(31):261-267.
[4]金新,王君影,李佩忠.乳突切除术合并一期鼓室成形术22例临床疗效分析[J].现代医学,2010,5(38):530-531.
[5]LANE J I,LINDELL E P,WITTE R J,et al.Middle and inner ear:improved depiction with multiplanar reconstruction of volumetric CT data[J].Radio Graphics,2006,26:115-124.
[6]FATTERPEKAR G M,DOSHI A H,DUGAR M,et al.Role of3D CT in the evaluation of the temporal bone[J].Radio Graphics,2006,26:117-132.
[7]宋庆轮,窦艳玲,叶奕兰,等.慢性化脓性中耳炎和胆脂瘤中耳炎致听骨链破坏的HRCT诊断价值[J].中国临床医学影像杂志,2012,23(4):265-267.
[8]赵东旭,牛玉军,盛玉杰,等.多层螺旋CT三维成像对慢性中耳乳突炎的诊断价值研究[J].解放军医学院学报,2014,35(1):56-59.
[9]景宏儒,陈志烈.胆脂瘤型中耳炎的高分辨率CT诊断价值[J].宁夏医学杂志,2010,32(10):956-957.
[10]吴莉,贾科峰,雷静,等.颞骨HRCT对慢性化脓性中耳炎锤、砧骨破坏评估[J].临床放射学杂志,2011,30(3):332-336.
[11]刘凯,柳澄,陈青华,等.颞骨高分辨率CT各向同性的研究[J].中华放射学杂志,2005,39(1):96-100.
[12]陈建军.中耳乳突炎和胆脂瘤的CT鉴别诊断[J].中国临床实用医学,2007,1(4):71-72.