传统CT与螺旋CT三维重建在伴有听骨链破坏的慢性中耳炎中的比较

Comparison of Conventional Versus Spiral Computed Tomography with Three Dimensional Reconstruction in Chronic Otitis Media with Ossicular Chain Destruction.

作者信息

Naghibi Saeed, Seifirad Sirous, Adami Dehkordi Mahboobeh, Einolghozati Sasan, Ghaffarian Eidgahi Moghadam Nafiseh, Akhavan Rezayat Amir, Seifirad Soroush

机构信息

Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran.

Department of Radiology, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Iran J Radiol. 2016 Jan 26;13(1):e9018. doi: 10.5812/iranjradiol.9018. eCollection 2016 Jan.

DOI:10.5812/iranjradiol.9018

PMID:27127583

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4841863/

Abstract

BACKGROUND

Chronic otitis media (COM) can be treated with tympanoplasty with or without mastoidectomy. In patients who have undergone middle ear surgery, three-dimensional spiral computed tomography (CT) scan plays an important role in optimizing surgical planning.

OBJECTIVES

This study was performed to compare the findings of three-dimensional reconstructed spiral and conventional CT scan of ossicular chain study in patients with COM.

PATIENTS AND METHODS

Fifty patients enrolled in the study underwent plane and three dimensional CT scan (PHILIPS-MX 8000). Ossicles changes, mastoid cavity, tympanic cavity, and presence of cholesteatoma were evaluated. Results of the two methods were then compared and interpreted by a radiologist, recorded in questionnaires, and analyzed. Logistic regression test and Kappa coefficient of agreement were used for statistical analyses.

RESULTS

Sixty two ears with COM were found in physical examination. A significant difference was observed between the findings of the two methods in ossicle erosion (11.3% in conventional CT vs. 37.1% in spiral CT, P = 0.0001), decrease of mastoid air cells (82.3% in conventional CT vs. 93.5% in spiral CT, P = 0.001), and tympanic cavity opacity (12.9% in conventional CT vs. 40.3% in spiral CT, P=0.0001). No significant difference was observed between the findings of the two methods in ossicle destruction (6.5% conventional CT vs. 56.4% in spiral CT, P = 0.125), and presence of cholesteatoma (3.2% in conventional CT vs. 42% in spiral CT, P = 0.172). In this study, spiral CT scan demonstrated ossicle dislocation in 9.6%, decrease of mastoid air cells in 4.8%, and decrease of volume in the tympanic cavity in 1.6%; whereas, none of these findings were reported in the patients' conventional CT scans.

CONCLUSION

Spiral-CT scan is superior to conventional CT in the diagnosis of lesions in COM before operation. It can be used for detailed evaluation of ossicular chain in such patients.

摘要

背景

慢性中耳炎（COM）可通过鼓室成形术治疗，可伴有或不伴有乳突切除术。在接受中耳手术的患者中，三维螺旋计算机断层扫描（CT）在优化手术规划中起着重要作用。

目的

本研究旨在比较COM患者听骨链的三维重建螺旋CT扫描和传统CT扫描的结果。

患者与方法

纳入本研究的50例患者接受了平面和三维CT扫描（飞利浦MX 8000）。评估听小骨变化、乳突腔、鼓室以及胆脂瘤的存在情况。然后由一名放射科医生对两种方法的结果进行比较和解读，记录在问卷中并进行分析。采用逻辑回归检验和一致性Kappa系数进行统计分析。

结果

体格检查发现62耳患有COM。两种方法在听小骨侵蚀（传统CT为11.3%，螺旋CT为37.1%，P = 0.0001）、乳突气房减少（传统CT为82.3%，螺旋CT为93.5%，P = 0.001）以及鼓室混浊（传统CT为12.9%，螺旋CT为40.3%，P = 0.0001）方面的结果存在显著差异。两种方法在听小骨破坏（传统CT为6.5%，螺旋CT为56.4%，P = 0.125）以及胆脂瘤存在情况（传统CT为3.2%，螺旋CT为42%，P = 0.172）方面的结果未观察到显著差异。在本研究中，螺旋CT扫描显示9.6%的患者存在听小骨脱位，4.8%的患者乳突气房减少，1.6%的患者鼓室容积减小；而在患者的传统CT扫描中均未报告这些发现。