CT-MRI图像融合技术应用于中耳胆脂瘤术前评估的效果  

The effectiveness of CT-MRI image fusion technology in the preoperative assessment of middle ear cholesteatoma

作　　者：张弛[1,2] 关亚峰 黄惠娥 耿娟娟 周正根 崔勇 Zhang Chi;Guan Yafeng;Huang Huie;Geng Juanjuan;Zhou Zhenggen;Cui Yong(Department of Otorhinolaryngology,Guangdong Provincial People′s Hospital,Southern Medical University,Guangzhou 510080,China;Department of Otorhinolaryngology,Guangzhou Women and Children′s Medical Center,Guangzhou 510623,China;Department of Otorhinolaryngology,the Hong Kong University-Shenzhen Hospital,Shenzhen518053,China;the First Affiliated Hospital of Shantou University Medical College,Shantou515041,China;Department of Otorhinolaryngology,Guangzhou Hospital of Integrated Traditional and West Medicine,Guangzhou510800,China;Department of Radiology,Guangdong Provincial People′s Hospital,Southern Medical University,Guangzhou510080,China)

机构地区：[1]南方医科大学附属广东省人民医院耳鼻喉科,广州510080 [2]广州市妇女儿童医疗中心耳鼻喉科,广州510623 [3]香港大学深圳医院耳鼻喉科,深圳518053 [4]汕头大学医学院第一附属医院耳鼻喉科,汕头515041 [5]广州市中西医结合医院耳鼻喉科,广州510800 [6]南方医科大学附属广东省人民医院影像科,广州510080

出　　处：《中华医学杂志》2024年第48期4384-4390,共7页National Medical Journal of China

摘　　要：目的探讨CT-MRI图像融合技术应用于中耳胆脂瘤术前评估的效果。方法回顾性分析2018年9月至2020年1月于广东省人民医院接受手术的中耳胆脂瘤患者临床资料,通过开源软件3D Slicer对患者术前CT及MRI进行自动融合,再对融合后的内耳结构进行3D重建;通过观察融合图像的重合度并进行评分来评估融合效果,对融合欠佳的病例进行手动校准;分析CT-MRI图像融合技术对中耳胆脂瘤术前评估的价值。结果共纳入27例患者,男12例,女15例,年龄(40.0±16.2)岁。21例融合效果满意(评分≥3分),6例融合效果欠佳(评分<3分),该6例经过手动调整后融合效果评分均≥3分。CT、MRI及CT-MRI融合图像在鼓窦后区及乳突区对中耳胆脂瘤侵袭范围的诊断受试者工作特征曲线下面积(AUC)分别为0.621(95%CI:0.404~0.838)、0.803(95%CI:0.638~0.969)和0.841(95%CI:0.693~0.990);灵敏度分别为94.1%、70.6%和88.2%;特异度分别为30.0%、90.0%和80.0%;准确度分别为70.4%、77.8%和85.2%。结论内耳结构的3D重建可用于评估和校准CT-MRI图像的融合效果,基于上述方法的CT-MRI图像融合技术有助于中耳胆脂瘤的术前定位评估。ObjectiveTo evaluate the effectiveness of CT-MRI image fusion technology in the preoperative assessment of middle ear cholesteatoma.MethodsThe clinical data of patients with middle ear cholesteatoma who underwent surgery at Guangdong Provincial People′s Hospital from September 2018 to January 2020 were retrospectively analyzed.Preoperative CT and MRI of the patients were automatically fused using the open-source software 3D Slicer,followed by 3D reconstruction of the fused inner ear structures.The degree of overlap was assessed and scored to evaluate the image fusion quality,with manual adjustments made for cases with poor fusion.The value of CT-MRI image fusion technology in the preoperative assessment of middle ear cholesteatoma was then analyzed.ResultsA total of 27 patients(12 males and 15 females)aged(40.0±16.2)years were included.The fusion effect was satisfactory(score≥3)in 21 cases and poor(score<3)in 6 cases.After manual adjustments,all 6 cases achieved a satisfactory fusion effect(score≥3).The area under the receiver operating characteristic curve(AUC)values for diagnosing the extent of invasion of middle ear cholesteatoma in the retrotympanic and mastoid regions using CT,MRI,and CT-MRI fused images were 0.621(95%CI:0.404-0.838),0.803(95%CI:0.638-0.969),and 0.841(95%CI:0.693-0.990),respectively,with the sensitivity of 94.1%,70.6%and 88.2%,the specificity of 30.0%,90.0%and 80.0%,and the accuracy of 70.4%,77.8%and 85.2%,respectively.ConclusionsThe 3D reconstruction of inner ear structures can be used to assess and refine the fusion quality of CT-MRI images.This CT-MRI image fusion technology is valuable for the preoperative localization assessment of middle ear cholesteatoma.

关 键 词：胆脂瘤 中耳 CT-MRI融合 术前评估 三维成像 

分 类 号：R76[医药卫生—耳鼻咽喉科]