HRCT最大密度投影对外伤后锤砧关节脱位诊断价值  

Evaluation of MIP in HRCT in Incudomalleolar Dislocation after injury

作　　者：于丽[1] 孙晓卫[2] 丁元萍[3] 窦芬芬[2] 赵秋良[1] 

机构地区：[1]山东大学附属济南市中心医院耳鼻喉科,济南250013 [2]山东大学齐鲁儿童医院耳鼻喉科,济南250022 [3]山东大学齐鲁医院耳鼻咽喉头颈外科,济南250012

出　　处：《山东大学耳鼻喉眼学报》2012年第2期46-48,共3页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的探讨高分辨率CT(HRCT)最大密度投影对外伤后锤砧关节脱位的诊断价值。方法对10例(11耳)耳外伤后听力下降呈传导性聋患者行HRCT扫描,分别观察常规轴位、多平面重组冠状位及最大密度投影听骨链病变情况,并与手术结果比较。结果耳部常规轴位显示锤砧关节脱位4耳;多平面重组冠状位显示3耳;最大密度投影轴位和冠状位均显示锤砧关节脱位6耳。术中探查见锤砧关节脱位6耳,砧镫关节脱位1耳,鼓膜穿孔7耳(3耳合并锤砧关节脱位)。锤砧关节脱位术前听力损失小于40 dBHL的3耳未再行听骨链成形,另行人工听骨植入术3耳,砧镫关节脱位1耳,复位听骨,伴发鼓膜穿孔的3耳同时修补鼓膜。结论 HRCT最大密度投影对诊断外伤后锤砧关节脱位有重要价值。Objective To evaluate the diagnostic value of maximum intensity projection（MIP）in high-resolution computed tomography（HRCT）in Incudomalleolar Dislocation after injury.Methods 10 patients（11 ears） with traumatic head injury were scanned with HRCT,while the original data were processed with multiplanar reformations（MPR）and MIP.From the images generated by these techniques,the ossicular chain structure was observed and compared with the findings in the operation.Results Among the 10 patients（11 ears）,incudomalleolar dislocations were well visualized in 4 ears on axial CT images,and 3 ears on Multiple Planar Reconstruction coronal CT images.6 ears of incudomalleolar dislocation were identified by maximum intensity projection（MIP） both in axial and coronal CT images,which were further confirmed by the operation.During the surgery,there were 6 ears with incudomalleolar dislocation,7 ears with tympanic membrane perforation（combined with incudomalleolar dislocation in 3 ears）,and 1 ear with incudostapedial dislocation.Conclusion Maximum intensity projection with high-resolution CT can improve the diagnosis of incudomalleolar dislocation.

关 键 词：外伤 听骨链 X-线 体层摄影术 高分辨率 

分 类 号：R764.4[医药卫生—耳鼻咽喉科] R816.9[医药卫生—临床医学]