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目的 探讨螺旋CT检查在慢性化脓性中耳炎诊断分型及治疗中的价值。方法 对 65例 79耳慢性化脓性中耳炎行螺旋CT检查 ,将轴位HRCT、冠状位MPR及听骨链 3D重建图像与手术结果对比分析。结果 轴位HRCT、冠状位MPR图像对慢性化脓性中耳炎诊断分型能力基本相同 ,但对中耳细微结构的显示有一定差异。 3DCT对锤、砧骨破坏的显示能力优于轴位HRCT及冠状位MPR图像 ,对蹬骨细微结构的显示则较后两者差 ,3DCT不能单独用于中耳炎的诊断分型 ,需与 2DCT图像结合 ,三者结合对中耳炎诊断分型与手术结果比较符合率高 (89.9%～ 97.5 % ) ,误诊率 (2 .9%～ 6.0 % )及漏诊率 (0～ 14 .6% )低。结论 螺旋CT 3种图像相结合有助于慢性化脓性中耳炎诊断分型及手术方案的制定。
Objective To investigate the value of spiral CT in the diagnosis of chronic suppurative otitis media. Methods 65 cases of 79 cases of chronic suppurative otitis media were examined by spiral CT. The axial HRCT, coronal MPR and ossicular chain 3D reconstruction images were compared with the surgical results. Results axial HRCT, coronal MPR images of chronic suppurative otitis media diagnostic ability of the same, but there are some differences in the display of the middle ear microstructure. 3DCT showed superiority in the display of hammer and incus destruction than axial HRCT and coronal MPR images, but showed less difference in the microstructure of pedicled bone. 3DCT could not be used alone for the diagnosis of otitis media and was associated with 2DCT images (89.9% -97.5%), the misdiagnosis rate (2.9% ~ 6.0%) and the misdiagnosis rate (0-14.6%) were low in the diagnosis of otitis media. Conclusion The combination of three kinds of spiral CT images is helpful for the diagnosis of chronic suppurative otitis media and the development of surgical plans.