单能量去金属伪影算法重建联合重建技术在人工耳蜗CT成像质量中的评估  

Evaluation of CT imaging quality of cochlear implants by SEMAR combined reconstruction technique

作　　者：李嘉慧 魏凡钦 周春香[1] 王仙仁[1] 黄碧雪 孙启阳 熊观霞[1] LI Jiahui;WEI Fanqin;ZHOU Chunxiang;WANG Xianren;HUANG Bixue;SUN Qiyang;XIONG Guanxia(Department of Otolaryngology,First Affiliated Hospital of Sun Yat-sen University,Guangzhou,Guangdong,510080,China)

机构地区：[1]中山大学附属第一医院耳鼻咽喉科,广东广州510080

出　　处：《中国耳鼻咽喉头颈外科》2020年第6期333-337,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：广州市科技基金资助项目(201803010033)。

摘　　要：目的探讨320排CT单能量去金属伪影算法重建(single-energy metal artifact reduction algorithm,SEMAR)联合多平面重建(multi-planar reformation,MPR)及最大密度投影(maximum intensity projection,MIP)两种重建技术在人工耳蜗植入(cochlear implant,CI)术后的临床评估价值。方法对30例(34耳)CI术后患者行CT检查,对去伪影前后图像中耳蜗、电极伪影及骨结构均匀性进行评分,测量去伪影前后骨蜗管CT值。重建图像中对电极植入部位、单电极可见性进行评分,行电极计数并与术中植入的电极数进行配对t检验。结果去伪影前后耳蜗、电极伪影、骨结构均匀性评分比较,差异均有统计学意义(t=-6.116、-6.371、-6.764,P均<0.05);而骨蜗管CT值比较,差异无统计学意义(P>0.05)。重建图像在电极具体植入位置、单电极评分、电极计数及术中植入的电极数与术后CT图像计数的电极数一致性好(P均>0.05)。结论 SEMAR可明显减轻人工耳蜗电极金属伪影,提高CT图像质量,其联合MPR及MIP有利于精准评估电极植入位置及直接进行电极计数,在CI术后的电极评估中具有较好临床应用价值。OBJECTIVE To explore the clinical value of 320-row CT single energy metal artifact subtraction(SEMAR) technique combined with multi-planar reformation(MPR) and maximum intensity projection(MIP) after cochlear implantation(CI).METHODS Thirty patients (thirty-four ears) with cochlear implantation were included in the study.All the patients were scanned by 320-row CT.Then SEMAR artifact removal and related reconstruction were performed.CT images before and after artifacts reduction in cochlea,electrode artifacts and bone structure uniformity were scored,and CT value of the bone cochlear canal before and after artifacts reduction were measured.The specific implantation site of the electrode and the single electrode were scored.The electrodes were counted in the CT image and the number of implanted electrodes was performed by paired t-test.RESULTSBefore and after the artifact reduction,there were statistically significant differences in the uniformity scores of cochlea,electrode artifact and bone structure(t=-6.116,-6.371,-6.764,P all<0.05).However,no statistical difference was found in CT values of the bone cochlear canal(P>0.05).The electrode implantation position,single electrode score,electrode count and the number of electrodes implanted during the operation were consistent with the number of electrodes counted in the CT image after the operation(P>0.05).CONCLUSION SEMAR technology can significantly reduce metal artifacts in cochlea,improve CT image quality,and clearly display electrode and cochlea structure.SEMAR combined with MPR and MIP can make evaluation of electrode implantation position and counting of electrode accurate,which have good clinical prospect in the CI evaluation.

关 键 词：耳蜗植入术 体层摄影术 X线计算机 金属伪影 图像质量 

分 类 号：R764.9[医药卫生—耳鼻咽喉科] R816.96[医药卫生—临床医学]