咽鼓管上隐窝形态与胆脂瘤关系的研究  

Relation Between the Morphology of Supertubual Recess and Occurrence of Cholesteatoma

作　　者：黄虹[1] 曹和涛[1] 陆健[2] 王鸿帼[1] 张勤慧[1] 刘婷婷[1] 苏海[1] 周亚生[2] 

机构地区：[1]南通大学附属医院影像科,研究生226001 [2]南通大学附属第三南通医院影像科,226000

出　　处：《临床放射学杂志》2014年第2期185-189,共5页Journal of Clinical Radiology

摘　　要：目的探讨咽鼓管上隐窝(STR)形态与胆脂瘤的关系及意义。方法回顾性分析经手术病理证实、STR骨性结构完整的慢性化脓性中耳炎(肉芽肿型)16例(18耳)、胆脂瘤71例(71耳)的MSCT资料,将其分成胆脂瘤组、慢性化脓性中耳炎组及正常组(所有健耳)三组,由两位经验丰富的医师分别测量各组STR前后径(AP)、横径(T)、上下径(SI),比较各组间、正常组左侧及右侧STR大小及结合STR形态前后诊断准确性。每两组间STR三径线均值行两独立样本t检验,以受试者工作特征曲线分析测量结果。结果胆脂瘤组、慢性化脓性中耳炎组、正常组左侧及右侧耳STR的AP、T和SI平均值分别为:2.82±0.87、2.99±0.74和2.53±0.71;3.65±1.21、3.39±0.72和3.57±0.4;4.25±1.22、3.75±0.99和4.02±0.98及4.06±1.08、3.80±0.71和3.80±1.03。其中胆脂瘤组与慢性化脓性中耳炎组、胆脂瘤组与正常组AP、T和SI大小差异均有统计学意义(P<0.05);慢性化脓性中耳炎组与正常组及正常组不同侧别耳AP、T和SI大小差异均无统计学意义(P>0.05)。结合STR形态本组诊断准确性由73.0%提高到89.9%。AP、T和SI诊断胆脂瘤的准确性分别为76.8%、69.7%和84.5%。结论胆脂瘤患耳STR主要径线显著小于慢性化脓性中耳炎患耳及所有正常耳;推测STR形态较小或为一种先天变异状态,为胆脂瘤易患因素之一,可作为影像辅助诊断依据。Objective To investigate the relation between the morphology of supratubal recess（STR） and occurrence of cholesteatom. Methods MSCT images of 71 patients （71ears） with cholesteatoma and 16 patients（18 ears） with chronic otitis media with granuloma were analyzed retrospectively. All cases were divided into 3 groups ： cholesteatoma group, gran- uloma group, the rest normal ears saved as control group. 3 main diameters of STR, which were anterior to posterior （AP） diameter, transverse diameter （T） and superior to inferior （SI） diameter were measured by two expert radiologists. Com- pare the size of STR between ears with cholesteatoma and ears with chronic otitis media. ROC etlrve was used to analyze the measurement results. Results The mean AP, T and SI of STR in ears with cholesteatoma, ears with chronic otitis media and the left and right normal ears were： 2.82±0.87, 2.99±0.74, 2.53±0.71 ;3.65±1.21, 3.39±0.72, 3.57±0.4 ;4.25 ±1.22, 3.75 ±0.99, 4.02±0.98 and 4.06± 1.08, 3.80 ± 0.71, 3.80 ± 1.03. There were significant differ- ences of main diameters of STR between cholesteatoma ears and normal ears, or between cholesteatoma ears and chronic oti- tis media ears （ P 〈. 05 ）. There were no significant differences of main diameters of of STR between chronic otitisears and normal ears on both sides（P 〉 0.05）. Combined with STR, our diagnosis accuracy raised from73.0% to 89.9%. The di- agnosis accuracy of STR （ AP,T, SI） for cholesteatoma were 76.8 % , 69.7% , 84.5 %. Conclusion The three diameters of STR in cholesteatoma ears were smaller than those in chronic otitis ears and normal ears. A bypovolumetric STR could be a congenital variation of cholesteatoma susceptible factors, which can be used as an auxiliary diagnosis for cholesteatoma.

关 键 词：咽鼓管上隐窝体层摄影术 X线计算机多平面重组 中耳炎 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]