AP-HP, Otology, Auditory Implants and Skull Base Surgery Department, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, 75013, Paris, France.
Inserm UMR_S 1159, "Réhabilitation chirurgicale mini-invasive et robotisée de l'audition", F-75018, Paris, France.
Eur Radiol. 2019 Oct;29(10):5617-5626. doi: 10.1007/s00330-019-06120-z. Epub 2019 Mar 19.
To evaluate the appearance of mastoid and epitympanic obliteration using S53P4 bioactive glass (BG) granules in high-resolution computed tomography (HRCT) and MRI.
Patients undergoing mastoid and epitympanic obliteration between May 2013 and December 2015 were prospectively included in an uncontrolled clinical study. All patients underwent a temporal HRCT scan 1 year after surgery, aimed at evaluating the attenuation, homogeneity, and osseointegration of the BG granules, as well as the ventilation of the middle ear and the volume of the obliterated paratympanic spaces. If a cholesteatoma was found during surgery, additional MRI, including at least pre- and post-contrast T1-weighted, T2-weighted, and axial non-echo-planar diffusion-weighted (DW) sequences, was performed 1 year after surgery, to study the normal signal of the BG granules and the presence of residual cholesteatoma and/or other temporal bone pathologies.
Seventy cases were included. On 1-year HRCT, the mean attenuation of the BG granules was 888.34 ± 166.10 HU. The obliteration was found to be mostly homogeneous with partial osseointegration. The appearance of the BG granules having a low-intensity signal in T2-weighted imaging and DW MRI was always different from the appearance of cholesteatoma. A longer follow-up has shown no attenuation or signal modification of the BG granules compared with the 1-year imaging.
Radiological follow-up of patients operated on with mastoid and epitympanic obliteration using BG granules is effective using both HRCT and MRI. A cholesteatoma and/or other potential complications could easily be detected due to the specific radiological appearance of the BG granules.
• The appearance of mastoid and epitympanic obliteration by S53P4 bioactive glass (BG) granules on high-resolution computed tomography (HRCT) scans was homogeneous with an attenuation significantly higher than the attenuation of cholesteatoma and lower than mastoid bone attenuation. • The granules have a low-intensity signal on non-echo-planar diffusion-weighted sequences and on T2-weighted images and present contrast enhancement allowing the differential diagnosis with cholesteatoma and effective for the detection of other underlying temporal bone pathologies. • The volume and radiological appearance of the obliteration appear to be stable with time.
使用 S53P4 生物活性玻璃（BG）颗粒在高分辨率计算机断层扫描（HRCT）和 MRI 中评估乳突和鼓室后区闭塞的外观。
前瞻性纳入 2013 年 5 月至 2015 年 12 月期间行乳突和鼓室后区闭塞术的患者，进行一项无对照的临床研究。所有患者术后 1 年均行颞骨 HRCT 扫描，旨在评估 BG 颗粒的衰减、均匀性和骨整合程度，以及中耳通气和闭塞性鼓室旁间隙的容积。如果术中发现胆脂瘤，则术后 1 年进行包括术前和术后 T1 加权、T2 加权和轴向非回波平面扩散加权（DW）序列在内的 MRI，以研究 BG 颗粒的正常信号以及残留胆脂瘤和/或其他颞骨病变的存在。
共纳入 70 例患者。术后 1 年 HRCT 时，BG 颗粒的平均衰减值为 888.34 ± 166.10 HU。闭塞大多呈均匀性，部分存在骨整合。BG 颗粒在 T2 加权成像和 DW MRI 上呈低信号，与胆脂瘤的外观始终不同。更长时间的随访显示，与 1 年影像学检查相比，BG 颗粒的衰减或信号无改变。
使用 HRCT 和 MRI 对使用 BG 颗粒行乳突和鼓室后区闭塞术的患者进行影像学随访是有效的。由于 BG 颗粒的特定影像学表现，很容易检测到胆脂瘤和/或其他潜在并发症。
S53P4 生物活性玻璃（BG）颗粒行乳突和鼓室后区闭塞术的患者，其高分辨率计算机断层扫描（HRCT）上的外观呈均匀性，衰减值明显高于胆脂瘤，低于乳突骨衰减值。
颗粒在非回波平面扩散加权序列和 T2 加权图像上呈低信号，呈对比增强，有助于与胆脂瘤进行鉴别诊断，并能有效发现其他潜在的颞骨病变。
闭塞的容积和影像学表现随时间似乎稳定。
