Debeaupte Mathilde, Hermann Ruben, Pialat Jean-Baptiste, Martinon Amanda, Truy Eric, Ltaief Boudrigua Aicha
Department of ENT, Edouard Herriot Hospital, Hospices Civils de Lyon, Université Lyon 1, 5, place d'Arsonval, 69 003, Lyon, France.
Department of Radiology, Edouard Herriot Hospital, Hospices Civils de Lyon, Université Lyon 1, Lyon, France.
Eur Arch Otorhinolaryngol. 2019 Feb;276(2):315-321. doi: 10.1007/s00405-018-5214-y. Epub 2018 Nov 23.
To determine whether the diagnostic value of cone-beam computed tomography (CBCT) is equivalent or superior to that of multi-detector computed tomography (MDCT) for the radiological assessment of conductive hearing loss with intact tympanic membrane in adults. Evaluation of inter- and intraobserver variability and measurement of the radiation dosimetry associated with each technique were secondary objectives.
Prospective, single-center study.
Ten adults were included from April to June 2013. All patients underwent MDCT and CBCT with reconstruction of temporal bones. Two radiologists with ENT experience reviewed the results twice. Diagnostic agreement between MDCT and CBCT and inter- and intraobserver agreement was evaluated with the kappa statistic. Comparisons of dosimetry were evaluated by calculating the ratio of the CT dose index (CTDI) between MDCT and CBCT.
Diagnostic agreement between MDCT and CBCT was satisfactory (kappa = 0.69). Inter- and intraobserver agreement was also acceptable, and the average ratio of the CTDI of MDCT and CBCT was 4.01.
CBCT is a reliable method that uses a low dose of radiation to investigate conductive hearing loss with intact tympanic membrane in adults. Its relevance and potential superiority to MDCT in diagnosing middle ear pathologies such as otosclerosis remain to be demonstrated, but the preliminary data are promising.
确定在对成人鼓膜完整的传导性听力损失进行放射学评估时，锥形束计算机断层扫描（CBCT）的诊断价值是否等同于或优于多排探测器计算机断层扫描（MDCT）。评估观察者间和观察者内的变异性以及测量与每种技术相关的辐射剂量是次要目标。
前瞻性单中心研究。
2013年4月至6月纳入10名成年人。所有患者均接受了颞骨重建的MDCT和CBCT检查。两名有耳鼻喉科经验的放射科医生对结果进行了两次评估。使用kappa统计量评估MDCT和CBCT之间的诊断一致性以及观察者间和观察者内的一致性。通过计算MDCT和CBCT之间的CT剂量指数（CTDI）比值来评估剂量学比较。
MDCT和CBCT之间的诊断一致性令人满意（kappa = 0.69）。观察者间和观察者内的一致性也可以接受，MDCT和CBCT的CTDI平均比值为4.01。
CBCT是一种可靠的方法，使用低剂量辐射来研究成人鼓膜完整的传导性听力损失。其在诊断中耳病变（如耳硬化症）方面与MDCT相比的相关性和潜在优势仍有待证明，但初步数据很有前景。
