Study Of The Value Of MSCT In Diagnosis Of Chronic Suppurative Otitis Media

Objective To evaluate the value of multislice spiral computed tomography (MSCT) and its postprocessing images in diagnosis and clinical treatment of the chronic suppurative otitis media (CSOM).Materials and Methods Seventy-five cases including ninty ears were examined by MSCT of temporal bone. The images were reformed and reconstured in SUN workstation (Advantage Windows 4.2 or 4.0), and then on the basis of axial images, coronal and sagittal of multiplanar reconstruction images and CTVE of auditory ossicular chain, the classifications of chronic suppurative otitis media were diagnosed. The classification results on MSCT were compared with those of clincal and pathological results in all cases.Results The lesions such as the disruption of the ossicular chain showed in multislice spiral CT (axial images, coronal and sagittal of MPR) or CTVE image were in accord with clinical diagnosis and those seen in the operation, the accuracy was 95.6-97.8%, the sensitivity was 100%,90.9%,100% respectively. The disruption of the ossicular chain and bony erosion in the tympanic cavity and antrum were severe in the type cholesteatoma than the type granuloma of chronic suppurative otitis media. The direct axial plane and coronal, sagittal multiplanar reformation in diagnosing of the CSOM were correspondent, but in showing of the most middle ear structure and lesions were difference. The sagittal MPR images could delineate the anatomical details of the temporal bone and the adjacent relationship from the profile, and display better the tympanic and mastoid segment of the facial nerve canal. The sagittal MPR images were superior to axial and coronal MPR images in diagnosing of the CSOM and anatomical variance, and the fixed-point measures and location of the anatomy in the operation. The CTVE images were superior to axial and MPR images in showing of the change of malleus and incus, the contrary situation in showing stapes and abnormal soft-tissue and bony erosion of the tympanic cavity and antrum. Only CTVE image may not select application for definition, and must combine with the 2-D image. The rate of agreement between multislice spiral CT diagnosis by combination of four different imaging methods and definition of CSOM were higher than any one of them.Conclusion Combination of four different imaging methods (axial image, coronal and sagittal of MPR and CTVE) can help to the diagnosis of the CSOM and anatomical variances and otogenic introeranial and extraerania complications, and provide valuable information for project of clinical treatment and the choice of operative pathway...