Kanzara Todd, Virk Jagdeep Singh
Todd Kanzara, ENT Department, Countess of Chester Hospital, Chester, Cheshire CH2 1UL, United Kingdom.
World J Clin Cases. 2017 Jul 16;5(7):286-291. doi: 10.12998/wjcc.v5.i7.286.
To determine the sensitivity and specificity of high resolution computed tomography (HRCT) in the diagnosis of otosclerosis.
A systematic literature review was undertaken to include Level I-III studies (Oxford Centre for Evidenced based Medicine) that utilised HRCT to detect histology confirmed otosclerosis. Quantitative synthesis was then performed.
Based on available level III literature, HRCT has a relatively low sensitivity of 58% (95%CI: 49.4-66.9), a high specificity, 95% (95%CI: 89.9-98.0) and a positive predictive value of 92% (95%CI: 84.1-95.8). HRCT is better at diagnosing the more prevalent fenestral form of otosclerosis but remains vulnerable to inframillimetre, retrofenestral and dense sclerotic lesions, despite the advent of more advanced CT scanners with improved collimation.
Whilst the diagnosis of otosclerosis remains largely clinical, HRCT remains the gold standard imaging of choice for the middle ear and serves as a useful adjunct to the clinician, helping to delineate extent of disease and exclude other causes.
确定高分辨率计算机断层扫描（HRCT）在耳硬化症诊断中的敏感性和特异性。
进行系统的文献综述，纳入使用HRCT检测经组织学证实的耳硬化症的I-III级研究（牛津循证医学中心）。然后进行定量综合分析。
基于现有的III级文献，HRCT的敏感性相对较低，为58%（95%置信区间：49.4-66.9），特异性较高，为95%（95%置信区间：89.9-98.0），阳性预测值为92%（95%置信区间：84.1-95.8）。HRCT在诊断更常见的窗型耳硬化症方面表现更好，但尽管有了具有改进准直功能的更先进CT扫描仪，对于亚毫米、窗后和致密硬化性病变仍难以检测。
虽然耳硬化症的诊断在很大程度上仍基于临床，但HRCT仍然是中耳成像的金标准，对临床医生是有用的辅助手段，有助于明确疾病范围并排除其他病因。
