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目的评价多层螺旋CT(MSCT)在人工耳蜗植入术后电极评估中的应用价值。方法对23例已行人工耳蜗植入的患者做MSCT横断面检查及容积再现技术(VRT)重建。扫描参数为:120kV,100mAs,0.75mm准直器宽度,螺距为1,重建层厚1mm,高分辨骨算法重建。对感兴趣耳以0.1mm重建间距、FOV=50mm进行重叠放大重建,将图像传至工作站以VRT对感兴趣耳进行三维重建。结果MSCT横断面图像显示,电极在耳蜗内呈断续点状高密度影,并见少许金属伪影。VRT图像显示,电极在耳蜗内呈螺旋状走行,与耳蜗走行一致。21例植入Combi40+标准型电极患者VRT可清晰分辨每个电极在耳蜗内的位置,2例植入Combi40+压缩电极的患者VRT图像上只能分辨插入耳蜗前段的4～5个电极,其他插入电极相互之间难以区分。VRT显示电极数目的准确率约为87%(20/23)。结论MSCT结合VRT重建可清晰、直观、准确地显示电极在耳蜗内的形态和位置,并能准确显示大部分病例植入电极数目,是人工耳蜗植入术后观察植入电极直观而较准确的方法。
Objective To evaluate the value of multi-slice spiral CT (MSCT) in the evaluation of electrodes after cochlear implantation. Methods Twenty-three patients who underwent cochlear implants underwent MSCT cross-sectional examination and volume rendering (VRT) reconstruction. Scanning parameters: 120kV, 100mAs, 0.75mm collimator width, pitch 1, reconstruction thickness 1mm, reconstruction of high-resolution bone algorithm. The interested ear was reconstructed with 0.1mm reconstruction distance and FOV = 50mm. The image was transmitted to the workstation to reconstruct the ear of interest with VRT. Results MSCT cross-sectional images showed discontinuous point-like high-density electrodes in the cochlea and a little metallic artifacts. VRT images show that the electrode travels helically in the cochlea, consistent with the walking of the cochlea. The VRT images of 21 patients with Combi40 + standard electrodes clearly distinguished the position of each electrode in the cochlea. In 2 patients with Combi40 + compression electrodes, only 4 ~ 5 electrodes inserted into the anterior segment of the cochlea could be distinguished from other VRT images. Difficult to distinguish between each other. VRT shows the number of electrodes with an accuracy of about 87% (20/23). Conclusion MSCT combined with VRT reconstruction can clearly and intuitively display the morphology and position of the electrodes in the cochlea and can accurately display the number of electrodes implanted in most cases. It is more accurate and intuitive to observe the implanted electrodes after cochlear implantation method.