Comparison Study Of Temporal Bone CT Scan Image、MPR、CTVR Diagnostic Value In Diseased Ossicular Chain

Objective:to evaluate the ossicular chain lesion by using CT scan image,multi-planar reconstruction(MPR),CT volume reconstruction(CTVR)technique,to seek a more accurate and objective way to provide more accurate information for the surgical treatment of the lesion of the ossicular chain,it is helpful to improve the preoperative evaluation,select the surgical method,improve preoperative preparation and reduce the risk of surgery,so that the patient can have a better understanding of the disease.Methods:to select 35 patients with chronic suppurative otitis media and middle ear cholesteatoma with surgical treatment,the patient should have a history of intermittent ear discharge for 6 weeks and above,perforation of the eardrum,and conductive deafness.The seven parts of the ear bone chain were selected as the representative to evaluate whether they had been destroyed.According to the standard of intraoperative observation,the evaluation results of CT scan images(axial position and coronal position),MPR,CTVR,and combined diagnosis were performed to analyze the sensitivity and specificity of the statistical analysis,and to evaluate the advantages and disadvantages of different diagnostic methods.Results:the diagnostic sensitivity of CT scan imaging MPR and CTVR for the destruction of the auditory chain is 88.78%.71.43%64.29%;The difference between the CT and the MPR(χ~2=11.1304,P=0.0008),or the CTVR(χ~2=20.3462,P=0.0000)is statistically significant,and the difference between the MPR and the CTVR(χ~2=2.7692,P=0.0961)is not statistically significant.The diagnostic specificity of CT plain scan,MPR and CTVR for the destruction of the auditory chain is 40.14%;63.95%;82.31%;The difference between CT and MPR(χ~2=20.7627,P=0.0000),or CTVR(χ~2=56.5294,P=0.0000)is statistically significant,and the difference between MPR and CTVR(χ~2=20.4848,P=0.0000)is statistically significant.CT scan image and MPR combined diagnosis contrast CT scan,the sensitivity difference is statistically significant,and the specificity difference is statistically significant.Compared with MPR,the sensitivity difference is not statistically significant,and the specificity difference is statistically significant.CT plain scan and CTVR combined diagnosis are compared with CT scan.The sensitivity difference is statistically significant,and the specificity difference is statistically significant.Compared with CTVR,the sensitivity difference is not statistically significant,and the specificity difference is not statistically significant.MPR and CTVR combined diagnosis contrast MPR,the sensitivity difference is statistically significant,specific degree difference is statistically significant,comparing CTVR,the sensitivity difference is not statistically significant,and the specificity difference is not statistically significant.Conclusions:The diagnosis of ossicular chain destruction in patients with chronic otitis media and middle ear cholesteatoma using CT plain scan images,MPR,and CTVR postprocessing techniques has advantages and disadvantages.CT plain scan images have a better diagnostic sensitivity than MPR for ossicular chain destruction.CTVR technology is less specific than MPR and CTVR.CTVR has no significant difference in sensitivity from MPR,but its specificity is better than that of MPR.CT plain scan images can be combined with CTVR technology to assess the destruction of the ossicular chain in patients with chronic suppurative otitis media and middle ear cholesteatoma undergoing surgical treatment to help choose a more appropriate surgical approach and reduce surgery risk.