Sun Xiao-wei, Zhang Jian-ji, Ding Yuan-ping, Dou Fen-fen, Zhang Han-bing, Gong Ke-bo, Xu An-ting
Department of Otorhinolaryngology, Qilu Children's Hospital of Shandong University, Jinan 250022, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 May;46(5):388-92.
To evalute the efficacy of high-resolution CT(HRCT) in differential diagnosis and treatment of chronic suppurative otitis media and cholesteatoma otitis media by soft-tissue shadows.
HRCT scanning was performed in 120 cases, 153 ears, with chronic otitis suppurative media and cholesteatoma otitis media, of which original data were processed with multi-planar reconstruction (MPR) and maximum intensity projection (MIP), the characteristics of the soft-tissue shadows' growth, window width or window leveling and bony destruction were respectively observed, as well as compared with the surgery findings.
In 120 patients (153 ears), 109 ears were diagnosed as cholesteatoma otitis media, and 44 ears were diagnosed as chronic suppurative otitis media, among which 33 ears had granulation tissue and 11 ears had secretion. One hundred and seven ears were postoperatively diagnosed as cholesteatoma otitis media, among which 25 ears had granulation tissue. Among 46 ears of chronic suppurative otitis media, 35 ears had granulation tissue, and only 11 ears had secretion. A 98.6% diagnostic accuracy can be reached with HRCT in diagnosing cholesteatoma otitis media and chronic suppurative otitis media. The Youden's index was 0.98, 0.98 and 1.00 respectively with HRCT in diagnosing cholesteatoma, granulation tissue and secretion.
Combination of the three different imaging methods, axial images, coronal MPR images and MIP images, can improve the efficacy of the HRCT diagnosis and definite chronic otitis media, which can be routinely used for surgery plan.
通过软组织阴影评估高分辨率CT（HRCT）在慢性化脓性中耳炎和胆脂瘤型中耳炎鉴别诊断及治疗中的疗效。
对120例（153耳）慢性化脓性中耳炎和胆脂瘤型中耳炎患者进行HRCT扫描，对原始数据进行多平面重建（MPR）和最大密度投影（MIP）处理，分别观察软组织阴影的生长特征、窗宽或窗位以及骨质破坏情况，并与手术结果进行比较。
120例患者（153耳）中，109耳诊断为胆脂瘤型中耳炎，44耳诊断为慢性化脓性中耳炎，其中33耳有肉芽组织，11耳有分泌物。术后107耳诊断为胆脂瘤型中耳炎，其中25耳有肉芽组织。慢性化脓性中耳炎46耳中，35耳有肉芽组织，仅11耳有分泌物。HRCT诊断胆脂瘤型中耳炎和慢性化脓性中耳炎的准确率可达98.6%。HRCT诊断胆脂瘤、肉芽组织和分泌物的约登指数分别为0.98、0.98和1.00。
轴向图像、冠状MPR图像和MIP图像三种不同成像方法相结合，可提高HRCT诊断慢性中耳炎的效能，为手术方案制定提供依据，可常规应用。
