听小骨“杠杆”层面在慢性中耳炎术前评估中的作用  

Role of ossicular lever plane in pre-operative evaluation of chronic otitis media

作　　者：刘东 巩若箴[2] 姜辉 全勇[3] 徐康洁[3] 孙百胜 杨东[3] 

机构地区：[1]武警山东省总队医院影像科,山东济南250014 [2]山东省医学影像学研究所,山东济南250021 [3]山东大学医学院,山东济南250012

出　　处：《中国耳鼻咽喉头颈外科》2011年第7期345-347,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨多层螺旋CT听小骨"杠杆"层面在慢性中耳炎所致听骨链中断术前评估中的价值。方法回顾性分析56例经手术证实均有听骨链中断的慢性中耳炎患者的高分辨率CT图像,应用最大密度投影(maximum intensity projection,MIP)方法重建听小骨"杠杆"层面,对照组观察听骨链的结构及整体形态,病变组观察听骨链中断部位及整体形态。以手术结果为标准,统计分析听小骨"杠杆"层面MIP图像显示听骨链中断的敏感性、特异值、阳性预测值、阴性预测值。结果对照组48耳听小骨"杠杆"层面MIP图像均显示听骨链的整体形态及结构。病变组64耳听小骨"杠杆"层面MIP图像显示,33耳在锤骨柄、锤骨颈段中断,34耳在锤骨头、砧骨体、锤砧关节段中断,50耳在砧骨长脚段中断,33耳在镫骨、砧镫关节段中断。听小骨"杠杆"层面MIP图像在显示听骨链中断的总体敏感性、特异性、阳性预测值、阴性预测值分别为93.8%、95.7%、91.3%、97%。结论听小骨"杠杆"层面MIP图像可直观显示听骨链连续性中断的部位及整体形态,对临床确定听骨链重建方式有重要意义。OBJECTIVE To explore the value of the ossicular lever plane in diagnosing of the discontinuity of ossicular chain in patients with chronic otitis media.METHODS The CT data of 56 patients with discontinuity of osscicular chain in chronic otitis media was retrospectively analyzed.All the cases were confirmed by operation.The ossicular lever plane was reformed by maximum intensity projection（MIP）technique.The shape and structures of the ossicular chain in 48 normal ears were analyzed.The discontinued part and shape of the whole osscicular chain in affected ears were also analyzed.The results were compared with the ？ndings in operation.The sensitivity,specificity,positive predictive and negative predictive value of the ossicular lever plane MIP image in displaying the discontinuity of osscicular chain were calculated respectively.RESULTS The shape and structures of the ossicular chain in 48 normal ears were displayed clearly by the ossicular lever plane MIP image.The discontinued part and shape of the osscicular chain in 64 affected ears were displayed clearly.The sensitivity,specificity,positive predictive and negative predictive value were 93.8%、95.7%、91.3%、97% respectively.CONCLUSION The shape and discontinued part of the osscicular chain in patients with chronic otitis media were well displayed on the ossicular lever plane MIP image.It is helpful for preoperative evaluation and making proper operation plan.

关 键 词：中耳炎 化脓性 听小骨 体层摄影术 X线计算机 

分 类 号：R764[医药卫生—耳鼻咽喉科]