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目的:探讨耳颞部高分辨螺旋CT扫描以及三维重建成像(SSD)的临床应用价值。方法:对49例正常、79例耳部病变患者,采用高分辨螺旋CT扫描。层厚1mm,小视野FOV:5cm,矩阵512×512,放大1.5倍,骨算法FC30重建。床速1mm?s,螺矩1,0.2mm小间隔重建,放大5倍,阈值最小值100～300Hu,最大值4085Hu,近于无穷大。电压120kV,电流50～200mA,窗位-50～300Hu,窗宽大于3000Hu。对15例病变行听骨链重建。结果:HRCT清晰显示了耳部微小病灶,明确了病变范围与周围结构的关系,对听骨链的大部破坏未做3D即明确诊断,而听骨链SSD更具有明显优越性,对锤骨、砧骨及锤砧关节的立体显示是常规CT不能比拟的,为临床制定手术方案提供了影像依据。结论:高分辨螺旋CT扫描有利于耳、颞部病变的诊断,可作为耳颞部更为可靠的影像筛选方法。SSD成像可选择性应用。
Objective: To investigate the clinical value of high resolution spiral CT and three dimensional reconstruction imaging (SSD) of the ear and temple. Methods: 49 cases of normal, 79 cases of ear disease, using high resolution spiral CT scan. Layer thickness 1mm, small field of view FOV: 5cm, matrix 512 × 512, enlarged 1.5 times, bone algorithm FC30 reconstruction. Bed speed 1mm? S, screw torque 1,0.2mm small interval reconstruction, enlarged 5 times, the minimum threshold 100 ~ 300Hu, the maximum 4085Hu, near infinity. Voltage 120kV, current 50 ~ 200mA, window level -50 ~ 300Hu, window width greater than 3000Hu. 15 cases of pathological reconstruction of ossicular chain. Results: The HRCT clearly showed the tiny lesions of the ear. The relationship between the extent of the lesion and the surrounding structures was clarified. The most of the damage to the ossicular chain was not diagnosed as 3D, but the ossicular chain SSD had obvious superiority. The three-dimensional display of incus and hammer anvil is unmatched by conventional CT, which provides an imaging basis for clinical planning of surgical procedures. Conclusion: High-resolution spiral CT scan is helpful for the diagnosis of ear and temporal lesions and can be used as a more reliable method of screening images of the ear and temple. SSD imaging can be applied selectively.