MSCT评估人工耳蜗植入术后电极形态及位置的初步研究  

Preliminary study on the electrode morphology and location of implanted cochlea by use of high-resolution MSCT

作　　者：袁丽琼 牟肖霖 肖亮 YUAN Li-qiong;MOU Xiao-lin;XIAO Liang(Department of Radiology,Chinese Medical University,Shengyang 110000,China)

机构地区：[1]中国医科大学附属第四医院,沈阳110000 [2]武汉市第五医院放射科,武汉430050 [3]大连市中心医院放射科,辽宁116033

出　　处：《放射学实践》2020年第4期467-472,共6页Radiologic Practice

摘　　要：目的:通过人工耳蜗术后MSCT扫描及三维重建,对人工耳蜗植入术后电极的形态及位置进行评估,探讨电极角度植入深度的影响因素、电极-蜗轴距离与临床调机参数听反应阈值的相关性。方法:29例(共33耳)行MED-EL人工耳蜗植入术的患者,于术后一周内行MSCT高分辨率扫描,观察电极对数目、植入圈数及位置;测量电极角度植入深度及线性植入深度、耳蜗底转直径及底转周长、电极-蜗轴间距离。记录术后每例患者人工耳蜗开机时听反应阈值。结果:所纳入的33耳植入电极数目均为12对,植入圈数1.0~2.5。电极角度植入深度在植入耳侧(左、右)和不同年龄(≤3y、>3y)组间的差异均无统计学意义(P>0.05);女性组角度植入深度略大于男性组(t=2.516,P=0.018);角度植入深度与线性植入深度(LID)呈正相关(R^2=0.328,P=0.001);电极角度植入深度与耳蜗底转直径及底转周长呈负相关(R^2=0.437,P<0.001;R^2=0.170,P=0.017)。电极-蜗轴间距离与听反应阈值THR呈正相关(R^2=0.013,P=0.026)。角度植入深度(Y)与线性植入深度(X1)、耳蜗底转直径(X2)所拟合的回归方程为Y=725.863+20.317X1-67.537X2(P<0.001)。结论:HRCT扫描及三维重建是评估人工耳蜗植入术后情况的一种有效手段;耳蜗大小及线性植入深度对术后电极角度植入深度有一定的预估作用。Objective:The purposes of this study were to evaluate the electrode morphology and location of multi-channel cochlear implants using three-dimensional(3D)reconstruction of high resolution MSCT scan,and so as to explore the influencing factors on electrode insertion depth angle,and the correlation between the distance of electrode-to-modiolus and threshold of hearing reaction(THR).Methods:Twenty-nine cochlear implant(MED-EL)recipients from January 2015 to October 2017 were involved in this study.A total of 33 ears of 29 patients underwent,MSCT scan on inner ear one week after the operation.3D reconstruction of the images were conducted and sent to Philips workstation to observe the location and morphology of the electrodes.The angular insertion depth,linear insertion depth(LID)of the electrode,the diameter and perimeter of the cochlear bottom and the distance of electrode-to-modiolus were measured.The THR of each patient was evaluated after the devices were switched on.Results:The number of implanted electrodes were 12 pairs among the 33 ears.Implanted turns were 1.0~2.5.There was no significant difference for the insertion depth angle between the groups with age≤3 years and>3 years(P>0.05),but with significant difference between male and female groups(P<0.05).The implantation depth of female group was slightly larger than that of male group(t=2.516,P=0.018).The insertion depth angle and linear insertion depth(X1)were positively correlated(R^2=0.328,P=0.001);the insertion depth angle were inversely correlated with the cochlear baseplate diameter(X2)and bottom rotation circumference(R^2=0.437,P<0.001;R^2=0.170,P=0.017).The distance between the implanted electrode and the cochlear axis was positively correlated with the THR(r=0.113,P=0.026).The regression equation of insertion depth angle(Y),linear insertion depth(X1)and cochlear baseplate diameter(X2)was Y=725.863+20.317X1-67.537X2(P<0.001).Conclusion:High-resolution MSCT scan with three-dimensional reconstruction after cochlear implantation is an effective evalu

关 键 词：人工耳蜗 电极 体层摄影术 X线计算机 角度植入深度 线性植入深度 

分 类 号：R814.42[医药卫生—影像医学与核医学] R764.9[医药卫生—放射医学]