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目的:通过高分辨率CT(HRCT)最大密度投影(MIP)对正常听骨链的观察,探讨其对慢性化脓性中耳炎听骨链病变的诊断价值。方法:对68例(136耳)患者进行HRCT扫描,自由模式分别沿各听小骨长轴行多平面重组,对重组图像行MIP重建,正常耳观察听骨链的结构形态,病变耳观察听骨链破坏情况并与手术结果比较。结果:54侧正常耳的听小骨MIP显示了听小骨的细微结构,还反映了听小骨之间的关系。慢性化脓性中耳炎82耳,MIP图像显示胆脂瘤型中耳炎41耳,39耳有听骨破坏,肉芽肿型中耳炎25耳,5耳有听骨破坏,单纯化脓性中耳炎16耳,未见骨质破坏。术中见胆脂瘤型中耳炎39耳骨质破坏,肉芽肿型中耳炎6耳有骨质破坏,单纯型无骨质破坏。结论:HRCT通过MIP可以清晰地显示正常听骨链及其空间结构,与轴位及冠状位图像相结合可以提高术前对听骨链病变的诊断率,有助于手术方式的制定。
OBJECTIVE: To observe the normal skeletal chain by high resolution computed tomography (HRCT) maximum density projection (MIP) and investigate the diagnostic value of ossicular chain disease in chronic suppurative otitis media. Methods: Sixty-six patients (136 ears) underwent HRCT scan. The free mode was performed with multi-plane reorganization along the long axis of each ossicular. MIP reconstruction was performed on the reconstructed images. The structure of the ossicular chain was observed under normal conditions. Chain damage and comparison with the surgical results. Results: The auditory ossicle MIP of 54 normal ears showed the fine structure of the auditory ossicles and also reflected the relationship between the auditory ossicles. Chronic suppurative otitis media 82 ears, MIP images showed cholesteatoma otitis media 41 ears, 39 ears with ossicular destruction, granulomatous otitis media 25 ears, 5 ears with ossicular destruction, purulent otitis media 16 ears, no bone damage. Surgery, see cholesteatoma otitis media 39 ear bone destruction, granulomatous otitis media 6 ears have bone destruction, simple boneless destruction. Conclusion: HRCT can clearly show the normal ossicular chain and its spatial structure through MIP. Combined with axial and coronal images, HRCT can improve the diagnosis rate of preoperative ossicular chain disease and contribute to the development of surgical methods.