正常听小骨高分辨CT三维体积重建评估  

Three-dimensional volume rendering reconstruction of the normal ossicular chain with 1024 high resolution CT

作　　者：郭勇[1] 刘阳[2] 逯巧慧[1] 王庆军[1] 史丽静[1] 王守海[1] 郑奎宏[1] 

机构地区：[1]海军总医院医学影像科,北京100048 [2]海军总医院耳鼻喉科,北京100048

出　　处：《实用放射学杂志》2013年第3期357-359,共3页Journal of Practical Radiology

摘　　要：目的 探讨中耳高分辨CT三维体积重建（3DVR）方法及其对正常听小骨的显示。方法 对60例单侧中 耳 炎患 者 行1 024高分辨CT扫描，对健侧中耳行3DVR重建。在工作站上通过放大、旋转观察中耳12个解剖结构的显示情况。采用3分分级方法，由1位放射科医生和1位耳科医生共同对12个解剖标志评分。结果 3DVR重建对锤骨、砧骨、砧镫关节等解剖结构完全清楚显示，锤砧关节显示为融合状态，砧骨豆状突54例（90%）表现为明显膨大或稍膨大，6例（10%）未见膨大。除1例镫骨后脚先天缺如外，其他镫骨前后脚均清楚显示。结论 中耳3DVR重建方法操作简便快捷，高分辨的图像使正常听小骨、特别是最小的镫骨清楚地显示，直观地再现了中耳立体结构,通过旋转观察中耳内结构接近耳科手术时显微镜的观察角度，为临床进一步评价听骨病变提供了一种新方法。Objective To explore a new reconstruction way of the middle ear with three-dimensional volume rendering techniques {31）VR） anct evaluate the anatomical details of the ossicular chain. Methods The temporal bone 1024 high resolution CT scans were obtained in 60 patients with unilateral otitis media. 3DVR of eontralateral normal middle ear was gained by define 6 lines nn coronal and axial referenced images. The 3I）VR images were reviewed jointly by one radiologist and one otologist on workstation and scored by using a three-point cluality rating for qualitative assessment of the 12 representative structures of the middle ear. Results The tietailed structures of the malleus, incus and ineudo-stapedial joint were all identified in all ears. The incudomalleolar joint appeared fused in all ears. Lenticular process of incus was detectable or clearly defined in 54 （90%） cases, not detectahle in 6 （10~} cases. The stapes anterior and posterior crura were seen cleariy on 3DVR images except one ear which had a congenital posterior crura absence. Conclusion 3DVR of the middle ear is an efficient way. The ossicular chain, especially the ultrastructures of the stapes, is well demonstrated. The demonstration of the middle ear structure by rotating the 3DVR image can provide different views of the os sicular chain which simulates otological microscopy and is quite comprehensive to the otologists. Further evaluation of pathologic conditions of the temporal bone with this method is expected.

关 键 词：计算机体层成像 三维重建 颞骨 中耳 听小骨 

分 类 号：R814.42[医药卫生—影像医学与核医学] R816.1[医药卫生—放射医学]