磁共振弥散加权成像在先天性中耳胆脂瘤精准诊断与JOS分期中的应用探讨12例  

Diffusion-weighted imaging for accurate diagnosis of congenital middle ear cholesteatoma and JOS staging

作　　者：万怡宁 张德军[1] 傅则名[1] 郭芳 郭颖媛[1] 管国芳[1] WAN Yining;ZHANG Dejun;FU Zeming;GUO Fang;GUO Yingyuan;GUAN Guofang(Department of Otorhinolaryngology&Head and Neck Surgery,The Second Hospital of Jilin University,Changchun 130041,China)

机构地区：[1]吉林大学第二医院耳鼻咽喉头颈外科,吉林长春130041

出　　处：《山东大学耳鼻喉眼学报》2021年第6期65-69,共5页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的探讨磁共振弥散加权成像(DWI)在先天性中耳胆脂瘤精准诊断中的价值,及DWI联合颞骨高分辨CT(HRCT)对先天性中耳胆脂瘤术前分期的准确性。方法选取12例先天性中耳胆脂瘤患者,评估DWI在先天性中耳胆脂瘤的诊断效能;结合HRCT及DWI检查,按照日本耳科协会(JOS)分期标准进行术前分期,所有患者均行手术治疗并记录术中分期情况。将术前分期与术中分期相比较,评估两者之间的一致性。结果12例患者术前DWI诊断准确率为100%。HRCT联合DWI术前分期:Ⅰb期2例,Ⅰc期1例,Ⅱ期8例,Ⅲ期1例;术中分期:Ⅰb期1例,Ⅰc期2例,Ⅱ期8例,Ⅲ期1例,两者一致性高达92%。结论DWI对检测先天性中耳胆脂瘤具有较高敏感性及特异性,可实现对先天性中耳胆脂瘤的精确诊断。同时将HRCT与DWI联合应用,可于术前实现精准分期,对该疾病的手术治疗及预后具有一定的指导意义。Objective To investigate the utility of diffusion-weighted imaging(DWI) for the accurate diagnosis of congenital middle ear cholesteatoma and the use of combining DWI with high-resolution computed tomography(HRCT) for the preoperative staging of congenital middle ear cholesteatoma. Methods Twelve patients with congenital middle ear cholesteatoma were selected to assess the diagnostic efficacy of DWI for congenital middle ear cholesteatoma. Preoperative staging was performed in accordance with the Japan Otology Society(JOS) staging criteria by performing both HRCT and DWI examinations. All patients underwent surgery and intraoperative staging. The findings of preoperative staging and intraoperative staging were compared to assess the consistency between them. Results DWI diagnosis was 100% accurate. HRCT combined with DWI for preoperative staging revealed congenital middle ear cholesteatoma of stage Ⅰb in two cases, stage Ⅰc in one case, stage Ⅱ in eight cases, and stage Ⅲ in one case. Intraoperative staging revealed the condition to be in stage Ⅰb in one case, stage Ⅰc in two cases, stage Ⅱ in eight cases, and stage Ⅲ in one case. The consistency between the two methods of staging was as high as 92%. Conclusion DWI has high sensitivity and specificity for detecting congenital middle ear cholesteatoma and can accurately diagnose the condition. At the same time, the combined use of HRCT and DWI can help establish precise staging before surgery, which can guide surgical treatment and indicate patient prognosis.

关 键 词：磁共振弥散加权成像 先天性中耳胆脂瘤 颞骨高分辨CT 分期标准 Levenson诊断标准 

分 类 号：R739.61[医药卫生—肿瘤]