Dulac G L
J Radiol Electrol Med Nucl. 1979 Jan;60(1):37-44.
Definition and technique of the Dulac 7 incidence. Diagrams 1 and 2 give details of the anatomical orientations which define this incidence. It is:--centered on the head of the malleus,--orientated in the plane of the ossicules or in the neighbouring plane of the ear-drum,--parallel to the general axis of the ossicules,--close to the perpendicular to the tegment tympani. This incidence is easy to obtain with our technique, using a fixed intracranial centering point, The transversal linear scanning is very effective and can be completed in a very short period. It should be noted, however, that in obese subjects with short necks, the entry point of the incidence is difficult to obtain as there is interposition of the neck muscles. Under these conditions, one should try to be as close to this entry point as possible, knowing that the results are still valid. Tomographic anatomy. A close examination of the text of figures 6, 7, and 8 will familiarize the reader with the tomographic anatomy of this incidence. To summarize the important information obtained from the Dulac 7 incidence we should note that in tomographies of normal petrous bones:--the attic is always perfectly visible, expecially its internal and external walls throughout their total length, and more especially the anterior wall;--the ossicles (head of the malleus, body of the incus, and their articulation) are always perfectly visible and distinct;--the inferior processes of the malleus and incus are always visible;--the external wall of the attic is visible throughout its length, more especially the anterior and posterior portions;--the anterior and posterior contours of the external auditory canal are particularly well-defined. Finally, this incidence also gives clear images of the temporo-mandibular joint, the antral region, the superior canal, and the internal auditory canal. A large experience of this incidence is required before interpreting the image of the foramen ovale. Tomographic pathognomonic signs. The texts of figures 9 to 24 are sufficiently demonstrative of the richness of the pathological data obtained from this incidence, without needing to repeat them here. We would only add that the degree of calcification of the ossicles and the anterior wall of the attic can be precisely determined. This incidence, therefore, gives valuable information in almost all middle ear affections. It is also necessary in order to study the external auditory canal.
杜拉克7投照的定义及技术。图1和图2详细展示了定义该投照的解剖学方位。其特点为:——以锤骨头部为中心;——位于听小骨平面或鼓膜相邻平面内;——与听小骨的总轴平行;——靠近与鼓室盖垂直的方向。运用我们的技术,通过固定的颅内对中点,很容易获得这种投照。横向线性扫描非常有效,且能在很短时间内完成。然而,需要注意的是,对于颈部短的肥胖受试者,由于颈部肌肉的阻挡,难以获得该投照的进针点。在这种情况下,尽管知道结果仍然有效,但应尽量靠近该进针点。体层解剖学。仔细研读图6、7和8的文字说明,读者将熟悉这种投照的体层解剖学。为总结从杜拉克7投照中获得的重要信息,我们应注意,在正常岩骨的体层摄影中:——鼓室上隐窝始终清晰可见,尤其是其内壁和外壁的全长,更特别是前壁;——听小骨(锤骨头部、砧骨体及其关节)始终清晰可见且界限分明;——锤骨和砧骨的下突始终可见;——鼓室上隐窝的外壁全长可见,更特别是前部和后部;——外耳道的前后轮廓特别清晰。最后,这种投照还能清晰显示颞下颌关节、窦区、上半规管和内耳道。在解读卵圆孔的图像之前,需要对这种投照有丰富的经验。体层诊断体征。图9至24的文字说明充分展示了从这种投照中获得的丰富病理数据,在此无需重复。我们仅补充一点,听小骨和鼓室上隐窝前壁的钙化程度可精确确定。因此,这种投照在几乎所有中耳疾病中都能提供有价值的信息。研究外耳道时也很有必要。