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目的探讨多层螺旋CT(multi slicecomputedtomography, MSCT)对先天性内耳发育畸形的诊断价值。方法对44例先天性感音神经性聋患者做MSCT横断面螺旋方式扫描及多平面重建(multi planarreformation,MPR),必要时做单侧重叠放大重建,并利用容积漫游技术(volumerenderingtechnique,VRT)对骨迷路进行三维重建。结果44例患者中25例CT表现正常, 19例(36耳)表现为内耳发育畸形。畸形有以下几种Michel型(1耳次),共同腔畸形(3耳次),不完全分隔I型(3耳次),不完全分隔II型(Mondini型, 5耳次),前庭及半规管畸形(14耳次),前庭导水管扩大(16耳次,其中6耳次伴随其他畸形),内耳道畸形(8耳次均伴随其他畸形)。36耳畸形中33耳MSCT横断面图像和MPR图像、VRT图像均可以清晰的显示畸形的部位和程度,其中VRT图像可以直观、立体地显示畸形的空间形态结构; 3耳水平半规管短小畸形患者VRT图像较断面图像更好的显示了畸形的部位和程度。结论MSCT提高了横断面图像以及MPR、VRT图像的空间分辨率。VRT图像直观、立体的显示了骨迷路畸形的空间形态结构,并且可以通过旋转多方位观察畸形的形态。MSCT扫描结合VRT可更加准确的对内耳骨迷路畸形的部位和程度做出诊断,加深了我们对各种畸形的理解,有助于人工耳蜗植入手术计划的制定。
Objective To investigate the diagnostic value of multi-slice computed tomography (MSCT) in congenital inner ear deformity. Methods Forty-four patients with congenital sensorineural hearing loss (MSCT) were examined by MSCT scan and multiplanar reconstruction (MPR). Unilateral overlapped reconstruction was performed if necessary. Volume displacement technique (VRT) Lost for three-dimensional reconstruction. Results Totally 25 cases of CT showed normal performance in 44 cases, and 19 cases (36 ears) showed deformity of inner ear. Deformity has the following types of Michel (1 ear), common cavity deformity (3 ears), incomplete separation of type I (3 ears), incomplete separation of type II (Mondini type, 5 ears), vestibular and semicircular canal Deformity (14 ears), vestibular aqueduct enlargement (16 ears, of which 6 ears accompanied by other deformities), internal ear canal deformities (8 ears were accompanied by other deformities). In 36 cases of ear deformity, 33 cases of MSCT cross-sectional images, MPR images and VRT images can clearly show the location and degree of deformity. VRT images can visually and stereoscopically display the deformity of spatial morphology; 3-ear horizontal semicircular canal shortening patients with VRT The image better shows the location and degree of deformity than the cross-sectional image. Conclusion MSCT improves the spatial resolution of cross-sectional images and MPR and VRT images. The VRT image shows the morphological structure of the bony labyrinth directly and stereoscopically, and can observe the morphology of the deformity by rotating the multi-orientation. MSCT scan combined with VRT can more accurately diagnose the location and degree of degenerative deformities of the inner ear and deepen our understanding of various deformities and contribute to the development of cochlear implant surgery plans.