人工耳蜗植入术前的影像学评估  

The preoperative imaging evaluation for cochlear implantation

作　　者：刘中林[1] 刘博[2] 何海丽 王振常[1] 付琳[1] 李永新[4] 郑军[4] 陈雪清[2] 宋妍[4] 李勇[1] 鲜军舫[1] 杨本涛[1] 兰宝森[1] 

机构地区：[1]首都医科大学附属北京同仁医院放射科,100730 [2]北京市耳鼻咽喉研究所 [3]河北省三河市医院放射科 [4]首都医科大学附属北京同仁医院耳鼻喉科,100730

出　　处：《中华放射学杂志》2006年第12期1256-1260,共5页Chinese Journal of Radiology

基　　金：北京市科技新星计划(2004-B-31)

摘　　要：目的分析人工耳蜗植入(CI)术前颞骨MRI及CT表现,并探讨术前影像学对人工耳蜗植入的价值。方法拟行CI的160例患者均行高分辨率CT扫描,64例同时行横、冠状面扫描,119例行MR检查。结果320耳乳突均气化良好,乳突蜂房向后超过乙状窦前壁206例。左、右侧乳突长度分别为(2.34±0.42)、(2.25±0.40)mm(U=1.887,P<0.05),宽度分别为(1.57±0.30)、(1.50±0.27)mm(U=2.35,P<0.05)。中耳炎8耳,CT示鼓室及乳突蜂房不含气,MRI为长T1,长T2信号。颈静脉球窝扩大或高位18耳,蜗窗龛狭窄2耳。迷路炎9耳,8耳CT表现耳蜗、半规管及前庭不同程度的骨化,MRI表现为长T1,短T2及短T1、等T2信号,并且T2WI信号不连续。1耳膜迷路闭塞,CT为阴性,MRI表现为等T1、等T2信号。耳蜗完全未发育1耳,耳蜗发育周数不足6耳,Mondini畸形5耳。前庭导水管扩大40耳,前庭、半规管发育畸形10耳,内耳道狭窄5耳。结论术前的颞骨影像学诊断,对于CI成功实施能够提供重要信息。Objective To analyze CT and MRI findings of temporal bone and to evaluate preoperative diagnostic value for cochlear implantation. Methods One hundred and sixty candidates for cochlear implantation were examined with axial CT scan, 64 of them also with coronal CT scan, and 119 patients with MRI. Results All of 320 ears were well-aerated, and 206 ears had mastoid cavities extended posteriorly to the sigmoid sinus. The length from posterior-lateral tympanic wall to the outer cortex was （ 2. 34± 0. 42） mm （ left side） and （ 2. 25 ± 0.40） mm（ right side） （ U = 1. 887, P 〈 0. 05 ）, and the width from anterior rim of the sigmoid sinus to posterior wall of the external auditory canal was （ 1.57 ±0. 30） mm （ left side） and （ 1.50 ± 0. 27 ） mm （ right side） （ U = 2. 35, P 〈 0.05）. Otomastoiditis occurred in 8 ears, and enlarged jugular fossa in 18 ears, narrowing of the round window niche in 2 ears, labyrinthitis ossificans in 9 ears, partial to complete ossification in 8 ears, and soft tissue obliteration in otic capsule in 1 ear with negative CT finding and isointense T1 and T2 signal on MRL The congenital malformations of inner ear occurred in 67 ears, including complete dysplasia in 1 ear, cochlear hypodysplasia in 6 ears, Mondini deformation in 5 ears, enlarged vestibular aqueduct in 40 ears, dysplastic semicircular canal and the vestibulae in 10 ears, and narrowing of internal auditory canal in 5 ears. Conclusion Preoperative imaging examinations can provide critical information to ensure successful cochlear implantation.

关 键 词：耳蜗植入术 体层摄影术 X线计算机 磁共振成像 

分 类 号：R445[医药卫生—影像医学与核医学]