计算机断层扫描密度作为耳硬化症组织学分级的生物标志物：一项人类颞骨病理学研究。

Computed Tomography Density as a Bio-marker for Histologic Grade of Otosclerosis: A Human Temporal Bone Pathology Study.

机构信息

Department of ENT, Rambam Health Care Campus, The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel.

Midwest Radiology, Roseville, Minnesota.

出版信息

Otol Neurotol. 2022 Jul 1;43(6):e605-e612. doi: 10.1097/MAO.0000000000003535.

DOI:10.1097/MAO.0000000000003535

PMID:35761453

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9245145/

Abstract

HYPOTHESIS

Computed tomography (CT) density measurement can be used to objectively distinguish otosclerosis from normal bone and to determine histologic grades of otosclerosis.

BACKGROUND

Otosclerosis can be seen on CT as subtle radiolucent areas. An objective radiologic measurement that corresponds to known otosclerosis pathology may improve diagnostic accuracy, and could be used as a radiologic biomarker for otosclerosis grade.

METHODS

A blinded, randomized evaluation of both histologic grade on histopathology slides and CT density measurement was performed on 78 human temporal bone specimens (31 with otosclerosis and 47 controls) that had undergone high-resolution multi-detector CT before histologic processing. Assessments were performed at 11 regions of interest (ROIs) in the otic capsule for each specimen.

RESULTS

The CT density measurement mean (Hounsfield Units) ± standard deviation for all ROIs (Nos. 1-9) was 2245 ± 854 for grade 0 (no otosclerosis, n = 711), 1896 ± 317 for grade 1 (inactive otosclerosis, n = 109), and 1632 ± 255 for grades 2 and 3 combined (mixed/active otosclerosis, n 35). There was a strong inverse correlation of CT density to histologic grade at ROIs Nos. 1-5 (ANOVA, p < 0.0001). The inter-rater reliability for CT density was very good (correlation coefficient 0.87, p < 0.05). ROC curves suggested a cut-off of 2,150HU to distinguish otosclerosis from normal bone, and 1,811HU to distinguish low grade from mixed/high grade otosclerosis.

CONCLUSIONS

In human temporal bone specimens, CT density may be used to distinguish normal bone from bone involved by otosclerosis. A higher histologic grade (i.e., indicating a more active otosclerotic focus) correlated with lower density.

摘要

假设

计算机断层扫描（CT）密度测量可用于客观地区分耳硬化症与正常骨，并确定耳硬化症的组织学分级。

背景

在 CT 上，耳硬化症可表现为细微的透亮区。与已知的耳硬化症病理学相对应的客观放射学测量可能会提高诊断准确性，并可用作耳硬化症分级的放射学生物标志物。

方法

对 78 个人颞骨标本（31 例耳硬化症和 47 例对照）进行了组织学分级的盲法、随机评估，这些标本在进行组织学处理之前均进行了高分辨率多探测器 CT 检查。对每个标本的 11 个感兴趣区（ROI）进行评估。

结果

所有 ROI（编号 1-9）的 CT 密度测量平均值（Hounsfield 单位）±标准差，0 级（无耳硬化症，n = 711）为 2245±854，1 级（非活动性耳硬化症，n = 109）为 1896±317，2 级和 3 级（混合/活动性耳硬化症，n = 35）为 1632±255。ROI 1-5 处 CT 密度与组织学分级呈强负相关（方差分析，p<0.0001）。CT 密度的观察者间可靠性非常好（相关系数 0.87，p<0.05）。ROC 曲线提示 2150HU 为区分耳硬化症与正常骨的截断值，1811HU 为区分低级别与混合/高级别耳硬化症的截断值。