Multislice Spiral Computed Tomographic Imaging In Middle-ear And Inner-ear

PurposeWe researched the MSCT scan and Post-operation of normal temporal bone to study optimal parameters that can demonstrate the structures of ear better in section , MPR , VR and VE . Then patients with ear diseases was examined in this parameters to assess the clinical application value of MSCT.Materials and methods一 ObjectivesNormal; fifteen normal (thirty ears ) subjects who coming for others reasons except for ear' s , performed head CT examination and was diagnosed having not the disease of the ear ,from July ,2004 to November.Case: eleven patients (fourteen ears) with long or repeating purulence, ache, audition descend of ear .二 Imaging equipment16 slice spiral CT (Philips MX 8000 IDT ) ,VxView 5.0 workstation三 Examination method1 Normal(1) The temporal bone was scanned from upper petrous part of temporal bone to lower external auditory canal with use of supraorbital-ear line as the base line , then was enlarge-reconstructed with use of the vestibule as the center. The concrete parameters of scan and reconstruction ; ① Reconstruction Function C , Reconstruction Matrix 512 ×512 , scanning with 200mAs/slice and 300mAs/slice separately ;②Current 200mAs/slice , Reconstruction Matrix 512 x 512 , reconstructing with function B . C . D separately ;③Current 200mAs/slice , Reconstruction Function C , reconstructing with matrix 512 × 512 ,1024 × 1024 separately.(2)Post-operation of the middle-ear and inner-ear , including MPR , VR and VE ,was performed in this two groups datas which was scanned and reconstructed with normal condition ( Current 200mAs/slice , Reconstruction Function C , Reconstruction Matrix 512 ×512 ,named Ⅰ ) and experiment condition (Current 300mAs/slice , Reconstruction Function C , Reconstruction Matrix 1024 × 1024 , named Ⅱ ) . The two groups datas was all enlarge-reconstructed unilateral.2 CaseThe patient who was diagnosed as chronic pyogenic tympanitis with condition Ⅰ ,was scanned and enlarge-reconstructed again with condition Ⅱ . Then post-procession , include MPR , VR and VE , was performed in the workstation .四 Estimate of image1 Normal groupThe estimate of the section and post-operation image was performed by two radiology doctor with blind method . The estimate standard of section image : 3 , the detail of structure can be recognized clear , and the neighbourhood can be judged straight ; 2 , the detail of structure can be recognized , but not clear or the neighbourhood could not judged straight ; 1 , the structure can be seen , but not the detail , only the character ; 0 , the structure could not be seen . The estimate standard of post-operation image : 2 , the structure can be seen clear , full , continuous ,and have third dimension ; 1 ,the structure can be seen but not clear ,not full ; 0 ,the structure could not be seen.2 Case groupWe compared what we seen in the images of ear with disease , include section , MPR , VR and VE in the two conditions and Estimated incrassation or sunken or perforation of eardrum , bad aerification of processus mastoideus , parenchyma in tympanic cavity and antrum mastoideum , destruction of tympanic cavity or antrum mastoideum , auditory ossicular chain shift or destruction , anddestruction of semicircular canal , tegmen tympani , sinus sigmoideus , facial canal and so on . The destruction of ossicula auditus was estimated in image of MPR ,VR and VE in the two conditions .五 Statistic methodTo analyze the data of current and matrix group of section and MPR , VR , VE with Paired-Samples T Test . To analyze the data of Reconstruction Function group of section with One-Way ANOVA Test. To analyze the influence of current , function and matrix on the display of head and neck of stapes , crus anterius , crus posterius , base of stapes , stapedius and chordal canal in section with Wilcoxon Signed Rank Test . To analyze the influence of the two conditions on the display of head and neck of stapes , cms anterius , crus posterius , base of stapes , stapedius and chordal canal in MPR ,VR and VE with Wilcoxon Signed Rank Test .Results一 The section of normal group1 It is significant that the difference between the quality of images with different current and matrix . The quality of images with different function is not same . The quality of C is better than D and D is better than B .2 It is significant that the difference between the scores of image quality of head and neck of stapes , cms anterius , cms posterius , base of stapes , stapedius and chordal canal with different current . The scores of head and neck of stapes , cms anterius , cms posterius , base of stapes , stapedius and chordal canal is not same when the function is different . Taking one with another , the quality of C is better than D and D is better than B . It is significant that the difference of the scores of the image of head and neck of stapes with different matrix .二 The post-operation of normal groupIt is significant that the influence of condition on the image' s quality of MPR ,VR and VE . When using the condition Ⅱ ,MPR ,VR and VE display the structures of middle-ear and inner-ear and head and neck of stapes , cms anterius , cms posterius , base of stapes , stapedius and chordal canal better than using...