梅尼埃病的颞骨螺旋CT三维影像学研究  

A study of three dimensional image of the temporal bone in Mé nière′s disease by spiral CT

作　　者：邢巍巍[1] 谷京城[1] 雷震[2] 武克俭[2] 张艳[2] 

机构地区：[1]锦州医学院附属第一医院耳鼻咽喉科,121001 [2]锦州医学院附属第一医院放射科,121001

出　　处：《耳鼻咽喉（头颈外科）》2002年第1期10-15,共6页Chinese Arch Otolaryngology-Head Neck Surg

摘　　要：目的：通过观察梅尼埃病（Ｍéｎｉèｒｅ′ｓ ｄｉｓｅａｓｅ，ＭＤ）患者前庭小管（ｖｅｓｔｉｂｕｌａｒ ａｑｕｅｄｕｃｔ，ＶＡ）及其周围骨质发育情况，探讨ＭＤ的病理解剖学基础及其临床意义。方法：实验分为两组，正常耳组和ＭＤ组。对每个研究对象进行颞骨螺旋ＣＴ扫描。采用后颅窝内面观、表面法进行三维重建，仅保留颞骨岩部后面及乳突内面，其他骨质切掉，在三维方向上旋转切割后的图像，使前庭小管外口最为清晰，直接测量其宽度的最大径；在围绕外半规管的横向轴位二维重建图像上，选择显示外半规管及后半规管后外侧断面最清晰的层面，直接测量后半规管断面中心到颞骨岩部后面的最短距离，并在所有显示迷路的层面上观察迷路后有无气房。结果：所有研究对象ＶＡ外口均显示清晰，ＭＤ组（３７耳）ＶＡ外口宽度为３．９１±１．１７ｍｍ，正常耳组（６０耳）ＶＡ外口宽度为６．６２±１．６９ｍｍ，其差异具有非常显著性意义（ｔ检验Ｐ．＜０．０１＝；ＭＤ组Ｐ－Ｐ值为２．１６±１．０２ｍｍ，正常耳组Ｐ－Ｐ值为３．４１±１．５１ｍｍ，其差异具有非常显著性意义（ｔ检验Ｐ＜０．０１＝；ＭＤ组有迷路后气化者占１３．５％，正常耳组占７３．３％，其差异具有非常显著性意义（ｘ２检验?Objective:To investigate the fundamental pathological anatomy and clinical significance in Ménière′s disease(MD) by observing the development of the vestibular aqueduct(VA) and the bone around VA.Method:The experiment consisted of two groups:Control group was 30 normal subjects(22 males and 8 females,ranging in age from 18 to 50 years old);MD group was 30 cases(16 males and 14 females,ranging in age from 17 to 62 years old).Spiral CT scanning was performed in all the subjects.A three-dimensional surface reconstruction method was used and the temporal bone was displayed from the occipital cranial fossa,bones other than the temporal bone were removed from the field of view.The reconstruction image was rotated carefully until the external aperture could be distinguished most clearly and its width was then measured directly on the image itself .Slice showing the lateral semicircular canal and retro-lateral section of the posterior semicircular canal most clearly was selected on two-dimensional transverse axial CT images,and the minimum distance between the posterior semicircular canal and the posteior petrous(P-P) surface was measured directly.Also,the retrolabyrinthine air cells were observed on all slices displaying labyrinthine.Result:The width of external aperture was 3.91±1.17mm in group of MD(37 ears),and 6.62±1.69mm in group of normal ears(60 ears).The difference was highly significant(t-test,P<0.01).P-P distance was 2.16±1.02mm in group of MD,3.14±1.51mm in group of normal ears.The difference was highly significant ( t-test,P<0.01).In the group of MD,13.5% were found to have retrolabyrinthin e air cells ,and 73.3% in group of normal ears,it was also considered statistically significant(P<0.01).A high degree of symmetry of the width of external aperture,P-P distance and retrolabyrinthine pneumatization was found.Conclusion:It was the fundamental pathological anatomy in MD that VA and the bone around VA are maldeveloped.Three-dimensional reconstruction of the external aperture of VA have valuable for d

关 键 词：Ménière病 前庭小管 诊断 CT 三维影像学 

分 类 号：R764.33[医药卫生—耳鼻咽喉科]