Department of Otolaryngology, Dijon University Hospital, Université Bourgogne-Franche Comté, Dijon, France.
Le2i Research Laboratory, CNRS UMR 6306, Université Bourgogne-Franche Comté, Dijon, France.
Acta Otolaryngol. 2020 Apr;140(4):270-276. doi: 10.1080/00016489.2020.1715472. Epub 2020 Jan 29.
Perilymphatic fistula (PLF) is a breach in a labyrinthine window. The opening might decrease the radiological density of the window. To evaluate the radiological density of the labyrinthine windows by virtual endoscopy on CT scan. This prospective study included 47 adult patients with PLF and 98 control patients. Diagnosis of PLF was based on a composite radio clinical score and/or intra operative visualization of the fistula and/or resolution of the symptoms after surgery. On routine CT-scan, labyrinthine windows were examined by virtual endoscopy. The reconstruction threshold was gradually increased until a virtual opening appeared (opening threshold [OT]) and compared to the contralateral window (OT difference). The OT difference was higher in patients than in controls (60.2 ± 10.36 (SEM), = 47 28.0 ± 2.29 Hounsfield units (HUs), = 98, < .01 unpaired -test). A ROC analysis showed that at an OT difference of 31.5 UH had a sensitivity of 75% and a specificity of 75% for the PLF diagnosis. CT-scan virtual endoscopy and threshold variation provided high specificity and sensitivity in the PLF diagnosis. This post processing of radiological data appears to enhance the diagnostic value of CT scan.
耳周瘘管（PLF）是迷路窗的破裂。开口可能会降低窗的放射密度。通过 CT 扫描虚拟内镜评估迷路窗的放射密度。这项前瞻性研究纳入了 47 例 PLF 成年患者和 98 例对照患者。PLF 的诊断基于综合放射临床评分和/或术中瘘管可视化和/或术后症状缓解。在常规 CT 扫描上，通过虚拟内镜检查迷路窗。重建阈值逐渐增加，直到出现虚拟开口（开口阈值[OT]），并与对侧窗口进行比较（OT 差值）。患者的 OT 差值高于对照组（60.2±10.36（SEM），n=47 28.0±2.29 单位（HU），n=98，p<.01 非配对 t 检验）。ROC 分析显示，OT 差值为 31.5UH 时，PLF 诊断的敏感性为 75%，特异性为 75%。CT 扫描虚拟内镜和阈值变化在 PLF 诊断中具有较高的特异性和敏感性。这种放射学数据的后处理似乎提高了 CT 扫描的诊断价值。
