Geisinger Medical Center, Danville, PA, USA.
Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
Ann Otol Rhinol Laryngol. 2021 Oct;130(10):1125-1131. doi: 10.1177/0003489421996844. Epub 2021 Feb 25.
This is a qualitative study to explore the utility of gray-scale inversion or the "invert" function of high-resolution computed tomography (HRCT) scans in the diagnosis of temporal bone anatomy and pathology.
This is a case series describing an innovative application of an existing image processing tool to visualize temporal bone anatomy and pathology. Illustrative patients at a tertiary referral center with otologic symptoms and findings leading to HRCT scans of the temporal bone were included. Diagnostic HRCT scans were evaluated utilizing the gray-scale inversion function (invert function).
Nine illustrative cases which demonstrate conditions such as persistent stapedial artery, membranous stapes footplate, total ossicular prosthesis migration into the vestibule, third window syndrome such as superior semicircular canal dehiscence (SSCD) and cochlea-facial nerve dehiscence, otosclerosis, and ossicular chain discontinuity are included. The enhanced visualization was confirmed surgically in 3 cases, and 1 had physiological confirmation using cervical vestibular evoked myogenic potentials (cVEMP).
Gray-scale inversion can be used to improve visualization of temporal bone anatomy and pathologic changes when diagnoses are in doubt. The invert function is a useful adjunct in the armamentarium of both radiologists and otologists when evaluating HRCT of the temporal bone.
这是一项定性研究，旨在探讨高分辨率计算机断层扫描（HRCT）灰度反转或“反转”功能在颞骨解剖和病理学诊断中的应用。
本病例系列描述了一种创新性地应用现有图像处理工具来可视化颞骨解剖和病理学的方法。选择在三级转诊中心因耳部症状和发现而进行颞骨 HRCT 扫描的患者。使用灰度反转功能（invert 功能）对诊断性 HRCT 扫描进行评估。
本研究共纳入 9 例具有代表性的病例，包括持续镫骨动脉、膜性镫骨足板、全听骨假体向鼓室迁移、上半规管裂（SSCD）和耳蜗面神经裂等第三窗口综合征、耳硬化症和听骨链中断等情况。其中 3 例经手术证实增强可视化效果，1 例采用颈性前庭诱发肌源性电位（cVEMP）进行生理确认。
当诊断存在疑问时，灰度反转可用于改善颞骨解剖和病理变化的可视化效果。在评估颞骨 HRCT 时，反转功能是放射科医生和耳科医生的有用辅助工具。
