MPR、SSD与VE混合重建图像对慢性中耳炎锤、砧骨破坏评估  

Evaluation of the destruction of the malleus and incus caused by chronic otitis media with the MPR and hybrid rendering method of the temporal bone HRCT

作　　者：吴莉[1] 韩丹[1] 宋光义[1] 

机构地区：[1]昆明医学院第一附属医院影像中心CT室,云南昆明650032

出　　处：《中国医学影像技术》2009年第S1期42-46,共5页Chinese Journal of Medical Imaging Technology

基　　金：2008年度云南省教育厅科学研究基金项目(08Y0220)

摘　　要：目的优化出颞骨高分辨率CT对慢性化脓性中耳炎(COM)锤、砧骨破坏部位显示的最佳重建及重建组合方法。方法对63例(66耳)COM患者进行颞骨HRCT扫描,分析锤、砧骨七部位(锤骨柄、头、颈、外侧突及砧骨长脚、短脚、体)轴位、多平面重组(MPR)、表面遮盖显示(SSD)与CT仿真内镜显示(VE)混合重建图像,采用配对卡方检验分别将上述观察方法与手术标本及病理结果比较分析。结果在对锤、砧骨七部位的显示中,轴位图像不能对其准确显示(P<0.001);MPR重组图像及SSD与VE混合重建图像能清晰、立体、直观地显示锤、砧骨破坏消失情况(P均>0.05),MPR重组图像较轴位图像更能反应锤砧骨各部位破坏情况(P均<0.05);MPR重组图像与SSD与VE混合重建图像结合观察锤、砧骨可降低漏诊率和误诊率;锤砧骨破坏程度不同听力损失程度不同(P<0.005);COM类型不同听力损失程度不同(P<0.005);胆脂瘤型中耳炎发生部位不同(上鼓室、中鼓室),对锤、砧骨破坏的部位及程度不同(破坏P<0.05,消失P<0.05)。结论MPR重组、SSD+VE混合重建均能较准确对锤砧骨评估,两种方法结合可降低对锤砧骨破坏的漏诊率和误诊率。Objective By optimizing the proper reconstruction and the combination of reconstruction methods processed with HRCT to detect the destruction of the malleus and incus caused by chronic otitis media(COM).Methods Scan sixty-three patients(sixty-six ears)of COM with HRCT.To observe the destruction of the malleus and incus with image of the original axial image,the multi-planar reconstruction(MPR)and the hybrid rendering,then compared them with the pathological specimens by Chi-square test.Results The axial image can't properly show the destruction of the malleus and incus(P<0.001).The image of MPR and hybrid rendering of SSD and VE can show the destruction of the malleus and incus clearly and directly(P>0.05);MPR combined with hybrid rendering can elevate the diagnostic ratio of the destruction of the malleus and incus.Conclusion MPR and hybrid rendering of SSD and VE can evaluate the destruction of the malleus and incus.

关 键 词：体层摄影术 X线计算机 多平面重组 中耳炎 化脓性 

分 类 号：R816.96[医药卫生—放射医学]