| Background and purpose:Ear anatomy is Sophisticated and complex, deep in the temporal bone, Previous which radiological methods include conventional X ray, conventional CT and magnetic resonance imaging (MRI) of the information provided is far can not meet the clinical needs. High-resolution CT (highresolution CT, HRCT) with high spatial resolution characteristics of the bone showed excellent detail, and its diagnosis of ear disease, the prominent role has been recognized, and its emergence to the development of ear imaging before a huge step forward, but the single-slice spiral CT, HRCT is usually only get a set of temporal bone of a plane parallel to the axial or coronal images. because of the angle as the limitations and often get treated with unbearable ,sagittal scan rack is difficult to obtain a special position.Chronic otitis media and cholesteatoma is the most common clinical ear disease, clinical types of treatment programs about chronic otitis media play a decisive role,and relying on clinical diagnosis solely is difficult. Multi-slice spiral CT three-dimensional reconstruction can find small bone destruction effectively, so it can give help to clinical classification and treatment. Of simple otitis media tympanoplasty, middle ear disease detection is important, multi-slice spiral CT three-dimensional reconstruction can be clearly identified lesions, particularly in the post-tympanic recess lesions with two more valuable, so that the success rate of surgery increased. For cholesteatoma lesions, but also provide more information, as indicated in attic cholesteatoma often observed in the tympanic shield plate damage, combined with clinical programs for the design of operation to provide reliable information to create the conditions for tympanoplasty.Multi-slice spiral CT three-dimensional display of post-processing techniques to the middle ear and inner ear structure of value has been unanimously endorsed by the majority of scholars. Therefore, this research is based on past experience, divided into two groups studied, namely, the normal group and cholesteatoma group, through the study of the normal group, more in-depth exploration of a variety of post-processing techniques MSCT middle ear, inner ear structure imaging value and the complementary relationship between them; and cholesteatoma group study chose cholesteatoma group, is due to benign lesions in the middle ear, cholesteatoma most likely to cause bone destruction, on the middle ear and inner ear structure imaging The study provides an important basis for lesion imaging, but also a higher incidence of cholesteatoma, select the cholesteatoma group has important clinical significance, through the study of cholesteatoma groups, specific post-processing techniques to explore their MSCT damage the value of bone imaging.The first part: A variety of post-processing techniques of MSCT studies on the normal middle ear and inner ear structure of imagingObjective discussion display capabilities of 64-row 128-slice CT image reconstruction technique in normal middle ear and inner ear structures.Materials and Methods This study used 64-row 128-slice CT in 50 normal ears for MSCT examination, carried out the reconstruction of a variety of ways, focusing on the auditory ossicles, cochlea structure application MPR and volume rendering techniques VR, facial nerve, semicircular canals Application of surface reconstruction CPR, respectively, arrived at a different display rates, all data is SPSS11.0 package deal, using x2 test provides p <0.05 statistically significant.Results Hammer and anvil joints, frog anvil joints, pedal bone forefoot, rear foot pedal bone, pedal bone floor of the five structures were in VR, MIP, MPR on the difference between the display rate, p value less than 0.05, the difference was statistically significant. Malleus handle, incus long-legged, hammer and anvil joints, frog anvil joints, pedal bone forefoot, rear foot pedal bone, pedal bone at the bottom of these seven structures were MSCT axial and post-processing image display rate difference, p value is less than 0.05, the difference was statistically significant. Facial nerve canal, superior semicircular canal, posterior semicircular canal and outside the semicircular canals, tympanic, tympanic antrum entrance, cochlear structure, the six structures in the different post-processing imaging with digital display on the axis are different, p value less than 0.01, the difference was statistically significant .Conclusions MSCT post-processing techniques on the normal middle ear, inner ear structure imaging advantages compared with axial imaging; MSCT post-processing techniques and the anvil of the stapes stapes joints showed somewhat less capable than other structures; MPR display of the stapes is superior to other imaging Methods; VR over MIP for the middle ear, inner ear fine structure (other than the anvil stirrup stirrup bone and joint) and the display is more intuitive, and accurate; CPR most suitable for the entire facial nerve canal imaging.The second part: A variety of post-processing techniques of MSCT on the middle ear and inner ear about cholesteatoma otitis media structure of bone destruction Obiective explore a variety of MSCT post-processing techniques to bone destruction in cholesteatoma otitis media to show the advantages and disadvantages. Materials and Methods In this study, with 64-row 128-slice CT cholesteatoma otitis media in 50 ears show the middle ear and inner ear structure in the reconstruction of a variety of ways, and compare MSCT examination results with surgical patients were seen in the control, blind judge the outcome, Kappa test between the two consistency, all data is SPSS11.0 package deal, the provisions of Kappa values of greater than or equal to 0.75 for the MSCT and intraoperative findings achieved considerable satisfaction degree of consistency. 0.4-0.75 description of its value in the line to a degree. Shows the same level of less than 0.4 is not ideal, and explain MSCT in cholesteatoma otitis media disease application.Results Hammer bone, incus long legs, short legs incus, incus body, meningeal wall of bone plate bone destruction, drums sinus entrance expanding the horizontal segment of facial nerve canal bone tube structure defects Kappa values were greater than 0.75, indicating MSCT showed their situation intraoperative findings consistent with a very high level; malleus handle, hammer and anvil joints, the horizontal segment of facial nerve canal, labyrinthine segment, semi-regulation, shield plate, sigmoid sinus bone wall, labyrinth structure of bone damage between the Kappa values in the 0.4-0.75 shows that MSCT to demonstrate its case in good agreement with the intraoperative findings; and anvil stirrup joint, stapes forefoot, rear foot stapes, the stapes bone damage floor Kappa value of less than 0.4, MSCT shows have seen the situation with the intraoperative consistency are relatively poor.Conclusions MSCT a variety of post-processing techniques cholesteatoma otitis media the middle ear, inner ear structure of bone imaging to surgical damage of important reference value; stirrup anvil stirrup bone and joint imaging of bone destruction is still a weak; simulation surgical approach can provide guidance on the preoperative assessment. |
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