先天性外耳道闭锁中面神经乳突段及鼓室窦的HRCT与3D VR CT图像变异

The image variations in mastoid segment of facial nerve and sinus tympani in congenital aural atresia by HRCT and 3D VR CT.

作者信息

Wang Zhen, Hou Qian, Wang Pu, Sun Zhaoyong, Fan Yue, Wang Yun, Xue Huadan, Jin Zhengyu, Chen Xiaowei

机构信息

Department of Otolaryngology, Peking Union Medical College Hospital, Beijing, PR China.

Department of Radiology, Peking Union Medical College Hospital, Beijing, PR China.

出版信息

Int J Pediatr Otorhinolaryngol. 2015 Sep;79(9):1412-7. doi: 10.1016/j.ijporl.2015.06.014. Epub 2015 Jun 22.

DOI:10.1016/j.ijporl.2015.06.014

PMID:26164212

Abstract

OBJECTIVE

To find the variations of middle ear structures including the spatial pattern of mastoid segment of facial nerve and the shapes of the sinus tympani in patients with congenital aural atresia (CAA) by using the high-resolution (HR) CT and 3D volume rendered (VR) CT images.

METHODS

HRCT was performed in 25 patients with congenital aural atresia including six bilateral atresia patients (n=25, 21 males, 4 females, mean age 13.8 years, range 6-19). Along the long axis of the posterior semicircular canal ampulla, the oblique axial multiplanar reconstruction (MPR) was set to view the depiction of the round window and the mastoid segment of facial nerve. Volumetric rending technique was used to demonstrate the morphologic features. HRCT and 3D VR findings in atresia ears were compared with those in 19 normal ears of the unilateral ears of atresia patients.

RESULTS

On the basic plane, the horizontal line distances between the mastoid segment of the facial nerve and the round window (h-RF) in atresia ears significantly decreased compared to the control ears (P<0.05). There was a significant negative correlation between the sinus tympani area (a-ST) and the distance between the horizontal lines of FN and RW midpoint (h-RF) (P<0.05). The mean area of sinus tympani in atresia group is larger (P<0.05). The shapes of the sinus tympani were classified into three categories: the cup-shaped, the pear-shaped and the boot-shaped. Area measurement indicated that the boot-shaped sinus tympani was a special variation with a large area, which only appears in CAA group. There were a significant difference between the area of the boot-shaped group and the other two groups (P<0.05). The morphologic differences of ST and other middle ear structures can also be observed visually in 3D VR CT images.

CONCLUSION

HRCT and 3D VR CT could help a better understanding of different kinds of variations in mastoid segment of facial nerve and sinus tympani in CAA ears. And it may further help surgeons to make the correct decision for hearing rehabilitation.

摘要

目的

通过使用高分辨率（HR）CT和三维容积再现（VR）CT图像，探寻先天性耳道闭锁（CAA）患者中耳结构的变异情况，包括面神经乳突段的空间形态以及鼓室窦的形状。

方法

对25例先天性耳道闭锁患者进行HRCT检查，其中包括6例双侧闭锁患者（n = 25，男21例，女4例，平均年龄13.8岁，范围6 - 19岁）。沿后半规管壶腹的长轴设置斜轴向多平面重建（MPR），以观察圆窗和面神经乳突段的显示情况。采用容积再现技术展示形态学特征。将闭锁耳的HRCT和3D VR结果与19例单侧闭锁患者的正常耳进行比较。

结果

在基面上，闭锁耳面神经乳突段与圆窗之间的水平直线距离（h - RF）相较于对照耳显著缩短（P < 0.05）。鼓室窦面积（a - ST）与面神经和圆窗中点水平线之间的距离（h - RF）呈显著负相关（P < 0.05）。闭锁组鼓室窦的平均面积更大（P < 0.05）。鼓室窦的形状分为三类：杯状、梨状和靴状。面积测量表明，靴状鼓室窦是一种具有大面积的特殊变异，仅出现在CAA组。靴状组与其他两组的面积存在显著差异（P < 0.05）。在3D VR CT图像上也可直观观察到鼓室窦和其他中耳结构的形态差异。