先天性内耳发育畸形的多层螺旋CT表现  

Appearance of Congenital Inner Ear Malformations by Multi Slice Spiral CT

作　　者：马辉[1] 韩萍[1] 梁波[1] 刘芳[1] 田志梁[1] 雷子乔[1] 孔维佳[2] 

机构地区：[1]武汉华中科技大学同济医学院附属协和医院放射科,430022 [2]武汉华中科技大学同济医学院附属协和医院耳鼻咽喉科,430022

出　　处：《临床放射学杂志》2006年第1期32-36,共5页Journal of Clinical Radiology

基　　金：湖北省卫生厅科研基金资助项目(JX1B057)

摘　　要：目的探讨先天性内耳发育畸形的多层螺旋CT表现。资料与方法回顾性分析17例(32耳)先天性内耳发育畸形患者的CT表现,所有患者均做多层螺旋CT横断面扫描及多平面重建,对患耳做单侧重叠放大重建,并利用容积再现技术(VRT)对骨迷路进行三维重建。结果本组先天性内耳发育畸形有以下几种:(1)Michel型(1耳):内耳结构完全缺如。(2)共同腔畸形(2耳):耳蜗和前庭呈一囊状结构,二者不能相互区分。(3)不完全分隔Ⅰ型(3耳):耳蜗缺乏完整的蜗轴,呈囊状改变,同时前庭扩大呈囊状。(4)不完全分隔Ⅱ型(Mondini型)(4耳):耳蜗仅1.5圈,中圈和顶圈融合,前庭扩大。(5)前庭及半规管畸形(14耳):耳蜗正常,前庭扩大,半规管短小、粗大或缺如。(6)前庭导水管扩大(14耳,其中6耳伴随其他畸形):前庭导水管扩大呈喇叭口状或与总脚相通。(7)内耳道畸形(8耳均伴随其他畸形):内耳道缺如、狭窄或扩大。结论先天性内耳发育畸形有其特殊的形态学表现,多层螺旋CT扫描结合后处理成像可清晰显示各种畸形的二维和三维解剖特征,对诊断有重要价值。Objective To discuss the multi slice CT（MSCT） appearance of the congenital inner ear malformations. Materials and Methods The MSCT appearance of 17 cases with inner ear malformations were reviewed retrospectively. The axial images of interested ears and multi-planar reconstruction were performed in each patient, the affected ear were done with magnified overlap recontruction, and the 3D reconstructions of inner ear labrinth were done with volume rendering technique. Results According to the results of common malformations were （ 1 ） Michel deformity （ 1 ear） ： There was complete absence of all cochlear and vestibular structures. （2） Common cavity deformity （2 ears）： There was a cystic cavity representing the cochlea and vestibule, but without showing any differentiation into coehela and vestibule. （3） In complete partition Ⅰ （3 ears） ： The cochlea was lacking the entire modiolus and cribriform area, resulting in a cystic appearance. This was accompanited by a large cystic vestibule. （4） In complete partition Ⅱ （Mondini deformity）（4 ears）： The cochlea consisits of 1.5 turns, in which the middle and apical turns coalesce to form a cystic apex, accompanied by a dilated vestibule and enlarged VA. （5） Vestibular and semicircular canal malformaitions （14 ears）： The cochlea is normal. Vestibule and the Lateral semicircular canal coalesce of the latter is small. （6） Vestibule aqueduct dilate （14 ears, of which 6 ears accompanied by other malformations） ： The dimension of the midisthmus of VA was more than 1.5mm. （7） Internal auditory canal malformations （all of 8 ears accompanied by other malformations） ： The internal auditory canal was absent, narrowed or dilated. Conclusion The congenital inner ear malformations have a special CT appearance in axial and 3D images. MSCT and the 3D reconstruction can provide a more clear and three dimensional view of the inner ear malformations, which is very useftd to the diagnosis of the congenital inner

关 键 词：内耳 畸形 多层 体层摄影术 X线计算机 

分 类 号：R816.96[医药卫生—放射医学]