慢性中耳乳突炎症听骨链标准化HRCT MPR评估  

Evaluation of Ossicular Chain in Chronic Otitis Media and Mastoiditis with Standardized HRCT MPR

作　　者：卢绍辉[1] 吴颋[1] 刘官华 刘家锋[1] 郭少华[1] 刘少强[1] 

机构地区：[1]赣南医学院第一附属医院CT/MR,江西赣州341000 [2]兴国县第二医院放射科,江西兴国342400

出　　处：《赣南医学院学报》2016年第1期42-45,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：2013年赣州市指导性科技计划任务项目

摘　　要：目的:评估HRCT及其标准化MPR后处理技术观察慢性中耳乳突炎症听骨链的方法及准确性。方法:搜集85例(92耳)经手术治疗的慢性中耳乳突炎症病例,术前采用螺旋CT高分辨扫描,将原始扫描数据放大重建后,标准组进行多平面重组(斜轴面、斜冠状面),以听小骨或听小骨关节部分或完全消失为破坏标准,以手术所见为金标准,并与非标准组结果比较。结果:92耳共276块听小骨及184个关节,标准组HRCT MPR观察125块听小骨破坏,手术证实122块;观察听小骨关节破坏68个,手术证实66个,准确性高于非标准组HRCT观察(χ2=21.652,P=0.000);Kappa值分别0.797,0.828,胆脂瘤型中耳炎(26耳)听小骨破坏率(71.8%)高于肉芽肿型中耳炎(66耳)听小骨破坏率(33.3%),差异有统计学意义(χ2=30.062,P=0.000)。结论:HRCT结合标准化MPR后处理,以听小骨或听小骨关节部分或完全消失为破坏标准,可以准确评估慢性中耳炎症听骨链状况,有利于指导治疗方案的制定;胆脂瘤型中耳炎听骨破坏率高于肉芽肿型中耳炎。Objective： To evaluate the accuracy of HRCT and MPR of ossicular chain in chronic otitis media and mastoiditis. Methods： There were 85 patients（ 92 ears） with chronic otitis media and mastoiditis undergoing high resolution spiral CT scans before surgery and receiving operative treatment. The original CT data were amplified and reconstructed.Partial or complete disappearance of auditory ossicles and joints taken as criterion of destruction and surgical findings taken as gold standards,the results of the standard group,in which multiplanar reconstruction（ axial,coronal,oblique axial,oblique coronal plane） was performed,were compared with those of the non-standard group. Results： There were276 auditory ossicles and 184 joints in these 92 ears. In the standard group,destruction of 125 auditory ossicles and 68 joints was showed with HRCT MPR and 122 auditory ossicles and 66 joints of them were confirmed by operation. The accuracy was higher than that of non-standard group by HRCT images（ χ2= 21. 652,P = 0. 000）. The value of Kappa was0. 797 and 0. 828 respectively. The ossicular destruction rate of cholesteatomatous tympanitis（ 26 ears,71. 8%） was higher than that of granulomatous otitis media（ 66 ears,33. 3%）,and their difference was statistically significant（ χ2=30. 062,P = 0. 000）. Conclusion： Partial or complete disappearance of auditory ossicles and joints taken as criterion of destruction,HRCT combined with standard MPR can be used to accurately assess the situation of ossicular chain in chronic otitis media and guide the establishment of therapeutic schedule. Besides,the ossicular destruction rate of cholesteatomatous tympanitis is higher than that of granulomatous otitis media.

关 键 词：中耳乳突炎症 体层摄影术 X线计算机 多平面重建 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]