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目的 探讨听骨链CT仿真内窥镜 (CTVE)的临床应用价值及其限度。方法 使用准直 1 0mm、螺距 1 0扫描 ,骨算法、视野 9 6cm、间隔 0 1- 0 2mm重建对 4 0例临床怀疑中耳病变(30例手术 )的患者进行CTVE成像 ,并与轴位高分辨率CT(HRCT)、多平面重组 (MPR)图像及手术结果进行对照分析。结果 CTVE诊断听小骨破坏的准确性为 92 6% ,明显高于轴位HRCT(84 % )和MPR(77% )图像。CTVE也能清楚地显示听骨链发育异常和术后的状况。结论 CTVE能显示听骨链的立体影像 ,有利于听骨链病变的显示和诊断。但CTVE不能清楚地显示鼓室腔内异常软组织、鼓膜和鼓室骨壁的异常改变 ,且结果易受人为因素影响。
Objective To investigate the clinical value and limitations of orthotopic cortex CT virtual endoscopy (CTVE). Methods CTVE imaging was performed on 40 patients with suspected middle ear lesions (30 surgeries) under the condition of alignment 10 0 mm, pitch 10 scanning, bone algorithm, field of view 9 6 cm, and interval 0 1 0 2 mm reconstruction. High-resolution CT (HRCT), multiplanar reconstruction (MPR) images and surgical results were analyzed. Results The accuracy of CTVE in diagnosing ossicular destruction was 92.6%, significantly higher than that of axial HRCT (84%) and MPR (77%). CTVE also clearly shows dysplasia and postoperative condition of ossicular chain. Conclusion CTVE can display three-dimensional images of ossicular chain, which is helpful for the display and diagnosis of ossicular chain lesions. However, CTVE can not clearly show abnormal changes in the tympanic cavity of abnormal soft tissue, tympanic membrane and tympanic wall, and the results are susceptible to human factors.