CT多平面重建的耳蜗标准化测量在先天性感音神经性耳聋患儿中应用价值  

Application of standardized cochlea measurement based on CT multi-planar reconstruction in children with congenital sensorineural hearing loss

作　　者：胡文 张增俊[1] 李胜利[2] 王冬[1] HU Wen;ZHANG Zengjun;LI Shengli;WANG Dong(Department of Imaging,Xi'an Children's Hospital,Xi'an 710003,China;Department of Otolaryngology,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安市儿童医院影像科,西安710003 [2]西安交通大学附属第二医院耳鼻喉科,西安710004

出　　处：《中华实用诊断与治疗杂志》2020年第2期191-194,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家自然科学基金(81170922)。

摘　　要：目的探讨高分辨率CT(high-resolution CT, HRCT)多平面重建耳蜗标准方位图像在先天性感音神经性耳聋(sensorineural hearing loss, SNHL)中的临床意义。方法 1~7岁经颞部CT诊断内耳骨性结构正常的SNHL患儿50例(100耳)为SNHL组,听力正常儿童50例(100耳)为对照组,根据耳蜗标准坐标系统,采用HRCT多平面重建技术得到标准方位图像,测量耳蜗底转长径、耳蜗底转宽径、耳蜗高度、斜轴位蜗神经管宽度、斜矢位蜗神经管宽度,采用曲面重建测量耳蜗管长度,ROC曲线评价各径线对SNHL患儿是否存在微小内耳畸形的诊断效能。结果 SNHL组耳蜗底转长径[(8.55±0.22)mm]、耳蜗底转宽径[(6.09±0.22)mm]、斜轴位蜗神经管宽度[(1.82±0.20)mm]、斜矢位蜗神经管宽度[(1.90±0.29)mm]、耳蜗管长度[(34.99±2.10)mm]小于对照组[(8.75±0.21)、(6.21±0.24)、(1.91±0.18)、(2.00±0.27)、(35.70±1.98)mm],耳蜗高度[(3.60±0.22)mm]低于对照组[(3.71±0.19)mm](P<0.05);耳蜗底转长径≤8.65 mm时,诊断SNHL患儿存在微小内耳畸形的AUC为0.739(95%CI:0.691~0.787),灵敏度为68.5%,特异度为70.5%。结论儿童耳蜗的标准化径线测量可靠性良好,耳蜗底转长径对SNHL存在微小内耳畸形及人工耳蜗植入术的指导有提示意义。Objective To explore the clinical significance of standard orientation image of high-resolution CT based on multi-planar reconstruction(MPR) in children with congenital sensorineural hearing loss(SNHL). Methods Fifty SNHL children(100 ears) with normal osseous structures of inner ear on CT aged from 1 to 7 years(SNHL group) and 50 children with normal hearing(100 ears)(control group) were obtained the standard orientation images by MPR according to the recognized planes of the cochlear coordinate system to obtain the length of cochlear base(BL), width of cochlear base, cochlear height, axial cochlear nerve canal and sagittal cochlear nerve canal. The cochlear length was measured with curve planer reconstruction. The efficiency of these diameters in the diagnosis of SNHL was analyzed by using ROC curve. Results The BL((8.55±0.22) mm), width of cochlear base((6.09±0.22) mm), axial cochlear nerve canal((1.82±0.20) mm), sagittal cochlear nerve canal((1.90±0.29) mm), and cochlear length((34.99±2.10) mm) in SNHL group were shorter than those in control group((8.75±0.21),(6.21±0.24),(1.91±0.18),(2.00±0.27),(35.70±1.98) mm)(P<0.05), and the cochlear height((3.60±0.22) mm) in SNHL group was lower than that in control group((3.71±0.19) mm)(P<0.05). When the BL was ≤ 8.65 mm, the AUC for diagnosing minor inner ear malformation in patients with SNHL was 0.739(95%CI:0.691-0.787), the sensitivity was 68.5% and the specificity was 70.5%, respectively. Conclusion High-resolution CT measurement of inner ear structures is reliable in children. The BL is of great significance in the diagnosis of minor inner ear malformation and the guidance of cochlear implantation in patients with SNHL.

关 键 词：感音神经性耳聋 耳蜗测量 多平面重建 蜗管长度 

分 类 号：R764.431[医药卫生—耳鼻咽喉科] R816.96[医药卫生—临床医学]