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目的 :探讨正常和异常听骨链三维 ( 3D)重建的成像方法及其临床初步应用。材料与方法 :采用 1 0mm、螺距1 0轴位薄层扫描 ,骨算法 ,FOV 9 6cm、间隔 0 1mm重建。对 10例正常中耳和 19例中耳病变 ( 14例手术 )的患者进行骨最大密度投影 (MIP)和表面遮盖法 (SSD) 3D重建。正常及异常中耳的观察阈值分别为 -5 0 0～ -2 0 0Hu和 10 0～3 0 0Hu。结果 :MIP和SSD 3D重建都能直观地观察锤、砧骨的形态、大小及相互关系 ,砧镫关节呈“L”形 ,镫骨前后脚及底板显示欠佳。 18例中耳炎患者中 12例胆脂瘤形成 ,3D重建显示有不同程度的听小骨破坏 ,SSD 3D的显示效果略好于MIP 3D。结论 :螺旋CT 3D成像能很好地显示正常和异常听骨链的立体影像 ,有利于听骨链病变的诊断。
Objective: To explore the imaging method of normal and abnormal ossicular chain three-dimensional (3D) reconstruction and its clinical application. Materials and Methods: Using 10 mm, pitch 10 axial thin layer scanning, bone algorithm, FOV 9 6cm, interval 0 1mm reconstruction. Ten patients with normal middle ear and 19 patients with middle ear disease (14 surgeries) underwent maximal bone density projection (MIP) and surface masking (SSD) 3D reconstruction. The normal and abnormal middle ear observation threshold values were -5 0 0 ~ -2 0 0 Hu and 10 0 ~ 3 0 0 Hu. Results: Both MIP and SSD 3D reconstruction could visually observe the shape, size and relationship of the hammer and incus. The anvils and joints were “L” shaped, and the anterior, posterior and anterior stapes showed poor performance. In 18 cases of otitis media, 12 cases of cholesteatoma were formed. 3D reconstruction showed different degrees of ossicular destruction, SSD 3D showed slightly better results than MIP 3D. Conclusion: Spiral CT 3D imaging can show the stereoscopic images of normal and abnormal ossicular chain, which is good for the diagnosis of ossicular chain lesions.