Bartling Soenke H, Gupta Rajiv, Torkos Attila, Dullin Christian, Eckhardt Grabbe, Lenarz Thomas, Becker Hartmut, Stöver Timo
Department of Neuroradiology, Hannover Medical School, Hannover, and Department of Diagnostic Radiology, Goettingen University Hospital, Goettingen, Germany.
Otol Neurotol. 2006 Jun;27(4):491-8. doi: 10.1097/01.mao.0000194816.15298.50.
Flat-panel based volume computed tomography could improve cochlear implant electrode evaluation in comparison with multislice computed tomography.
Flat-panel based volume computed tomography offers higher spatial resolution and less metal artifacts than multislice computed tomography. Both characteristics could improve the evaluation of challenging but important questions in cochlear implantation assessment, such as an exact imaging of cochlea, osseous spiral lamina, electrode array position, and single electrode contacts. These questions are not currently fully answered by multislice computed tomography.
Four isolated temporal bone specimens were scanned in a current multislice computed tomography scanner and in two experimental flat-panel based volume computed tomography scanners before and after cochlea implantation. To compare flat-panel based volume computed tomography and multislice computed tomography, four features were rated according to the following criteria: 1) visibility of the cochlea; 2) visibility of the osseous spiral lamina; 3) discernibility of individual electrode contacts; and 4) the ability to determine the electrode array position relative to scala tympani and scala vestibuli. Layer-by-layer microgrinding pictures were used as the ground truth for verification of imaging findings.
Flat-panel based volume computed tomography was superior to multislice computed tomography in all four features rated. The cochlea and facial nerve canal were much better delineated in flat-panel based volume computed tomography. The osseous spiral lamina and single electrode contacts were only visible in flat-panel based volume computed tomography. Assessment of implant position with regard to the cochlear spaces was considerably improved by flat-panel based volume computed tomography.
Cochlear implantation assessment could be improved by flat-panel based volume computed tomography and, therefore, would be highly beneficial for cochlea implantation research and for clinical evaluation. However, these first results were shown by scanning isolated temporal bone specimens; scanning whole human skull bases might be more challenging.
与多层计算机断层扫描相比，基于平板探测器的容积计算机断层扫描可改善人工耳蜗电极评估。
基于平板探测器的容积计算机断层扫描比多层计算机断层扫描具有更高的空间分辨率和更少的金属伪影。这两个特性都可以改善人工耳蜗植入评估中具有挑战性但很重要的问题的评估，例如耳蜗、骨螺旋板、电极阵列位置和单个电极触点的精确成像。多层计算机断层扫描目前尚未完全解决这些问题。
在人工耳蜗植入前后，对四个离体颞骨标本分别在当前的多层计算机断层扫描仪和两台基于平板探测器的实验性容积计算机断层扫描仪中进行扫描。为了比较基于平板探测器的容积计算机断层扫描和多层计算机断层扫描，根据以下标准对四个特征进行评分：1）耳蜗的可视性；2）骨螺旋板的可视性；3）单个电极触点的可辨别性；4）确定电极阵列相对于鼓阶和前庭阶位置的能力。逐层微磨片用作验证成像结果的金标准。
在所有四个评分特征中，基于平板探测器的容积计算机断层扫描均优于多层计算机断层扫描。基于平板探测器的容积计算机断层扫描对耳蜗和面神经管的描绘要好得多。骨螺旋板和单个电极触点仅在基于平板探测器的容积计算机断层扫描中可见。基于平板探测器的容积计算机断层扫描显著改善了对植入物相对于耳蜗间隙位置的评估。
基于平板探测器的容积计算机断层扫描可改善人工耳蜗植入评估，因此对人工耳蜗植入研究和临床评估将非常有益。然而，这些初步结果是通过扫描离体颞骨标本得出的；扫描完整的人类颅底可能更具挑战性。
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