From the Department of Radiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Dr Ovídio Pires de Campos 75, São Paulo, SP 05403-000, Brazil.
Radiographics. 2021 May-Jun;41(3):858-875. doi: 10.1148/rg.2021200126. Epub 2021 Mar 19.
The anatomy of the temporal bone is complex, and postoperative imaging evaluation of this bone can be challenging. Surgical approaches to the temporal bone can be categorized didactically into tympanoplasty and ossicular reconstruction, mastoidectomy, and approaches to the cerebellopontine angle and internal auditory canal (IAC). In clinical practice, different approaches can be combined for greater surgical exposure. Postoperative imaging may be required for follow-up of neoplastic lesions and to evaluate unexpected outcomes or complications of surgery. CT is the preferred modality for assessing the continuity of the reconstructed conductive mechanism, from the tympanic membrane to the oval window, with use of grafts or prostheses. It is also used to evaluate aeration of the tympanic and mastoid surgical cavities, as well as the integrity of the labyrinth, ossicular chain, and tegmen. MRI is excellent for evaluation of soft tissue. Use of a contrast-enhanced fat-suppressed MRI sequence is optimal for follow-up after IAC procedures. Non-echo-planar diffusion-weighted imaging is optimal for detection of residual or recurrent cholesteatoma. The expected imaging findings and complications of the most commonly performed surgeries involving the temporal bone are summarized in this review. RSNA, 2021.
颞骨解剖结构复杂，术后对该骨进行影像学评估具有一定挑战性。颞骨手术入路可分为鼓室成形和听骨链重建、乳突切除术以及桥小脑角和内听道（IAC）入路。在临床实践中，不同的入路可联合使用以获得更大的手术显露。术后影像学检查可能是为了随访肿瘤性病变，以及评估手术的意外结果或并发症。CT 是评估从鼓膜至卵圆窗重建的传音机制连续性的首选方式，可使用移植物或假体。它还可用于评估鼓室和乳突手术腔的充气情况，以及迷路、听骨链和鼓室盖的完整性。MRI 对软组织评估具有优势。在 IAC 手术后，使用增强对比脂肪抑制 MRI 序列进行随访最佳。非回波平面扩散加权成像对检测残余或复发性胆脂瘤最敏感。本文总结了最常施行的涉及颞骨的手术的预期影像学表现和并发症。美国放射学会，2021 年。
