颞骨MSCT及多种后处理技术在婴幼儿人工耳蜗植入术中的临床应用

Clinical application of multislice spiral CT for temporal bone and multiple post-processing reconstruction techniques for infant cochlear implantation

  • 摘要:
    目的 探讨颞骨多层螺旋CT(MSCT)及多种后处理技术在婴幼儿人工耳蜗植入术中的临床应用价值。
    方法 对50例术前和2例术后重度感音神经性耳聋(SNHL)患者行颞骨高分辨率CT平扫,应用双斜径多平面重建、面神经曲面重建、双阈值重建+透明成像+三维融合等后处理技术,对鼓岬平面面神经垂直段与外耳道后壁的距离、圆窗宽度进行测量及对内耳结构进行分析。
    结果 ① 50例术前患者中,内耳发育畸形7例,发病率为14.0%(7/50);慢性中耳乳突炎9例;另34例内耳、乳突未见明显异常。50例术前患者均清晰重建出内耳、听骨链三维结构,精确测量出鼓岬平面双侧面神经垂直段与外耳道后壁的距离右侧(0.33±0.057)cm、左侧(0.33±0.068)cm及双侧圆窗宽度右侧(0.14±0.027)cm、左侧(0.14±0.025)cm,完整显示出面神经走行路径。②2例术后复查患者均清晰显示出电极位置及术后改变情况。
    结论 部分先天性SNHL存在内耳发育畸形,颞骨MSCT高分辨扫描能清晰显示内耳畸形,同时应用多种后处理重建及测量技术,可为婴幼儿人工耳蜗植入术前提供更精确的颞部解剖影像信息和术后评估。

     

    Abstract:
    Objective To investigate the clinical application value of multislice spiral CT(MSCT) for temporal bone and multiple post-processing reconstruction techniques for infant cochlear implantation.
    Methods Fifty preoperative patients and two postoperative patients with severe sensorineural hearing loss(SNHL) underwent high-resolution temporal bone MSCT. Double-threshold reconstruction, transparent imaging and three-dimensional fusion, double-oblique diameter multiplanar reconstruction, and curved planar reconstruction were used to measure the distance between the vertical facial nerve and external acoustic canal and the round window breadth, as well as analyze the inner ear structure.
    Results ① Out of 50 preoperative patients, 7 showed inner ear malformations, 9 presented chronic tympanomastoiditis, and 34 exhibited normal ear structure. The probability of inner ear malformations was 14.0%. Before cochlear implantation, the inner ear structure and ossicular chain were clearly observed in all the patients enrolled in this study. The distance between the vertical facial nerve and external acoustic canal was (0.33±0.057) cm on the right side and(0.33±0.068) cm on the left side. The round window breadth was (0.14±0.027) cm on the right side and(0.14±0.025) cm on the left side. ②The electrodes and postoperative changes were clearly detected in two patients with cochlear implants.
    Conclusion Inner ear malformations were clearly shown by high-resolution temporal bone scanning in a number of SNHL patients. Multiple post-processing techniques can significantly obtain precise information on the temporal anatomical structure before cochlear implantation and provide accurate assessment of the operation.

     

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