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1、·592·中华现代影像学杂志JournalofChineseModernImaging2006年第3卷第7期·论著·颞骨螺旋CT扫描及三维重建的临床应用12韩本谊,李宏儒[摘要]目的探讨螺旋CT(spiralcomputedtomography,SCT)高分辨率扫描及扫描后三维重建对颞骨病变的诊断价值。方法颞骨螺旋CT薄层扫描,层厚1.0mm,骨算法,FOV9.6cm,间隔0.1mm密集重建。对34例正常和30例异常耳部进行三维重建和听骨链CT仿真内镜重建。结果64例病例中高分辨率CT显示双侧均正常34例(68耳),异常30例(44耳)。其中,中耳炎19例(29耳),胆脂
2、瘤2例(3耳),肉芽肿1例(1耳),前庭发育畸形1例(1耳),锤砧关节脱位1例(1耳),颈静脉球高位2例(2耳),颈静脉球高位伴静脉球裸露1例(1耳),前庭导水管扩大2例(4耳),耳蜗导水管扩大1例(2耳)。本组病例横轴位高分辨率CT图像和MPR图像可以清晰显示病变部位和程度,CTVE能立体显示听骨链空间形态和结构。结论横轴位HRCT及MPR可以显示耳部全部信息。CTVE能直接显示听骨链立体影像,但不能区分内表面密度差异。CT仿真内镜对中耳、听骨链仅可以做辅助诊断。[关键词]体层摄影术,螺旋计算机;仿真内镜;听骨链;三维重建[中图分类号]R764.21[文献标识码]A[文
3、章编号]1681-2824(2006)07-0592-03SpiralCTwiththree-dimentionalreconstructionforthetemporalboneanditsclinicalapplicationHANBen-yi,LIHong-ru.DepartmentofImageology,ShanghaiShidongHospital,Shanghai200438,China[Abstract]ObjectiveTodiscussthevalueofspiralcomputedtomography(SCT)withthree-dimentiona
4、l(3D)reconstructionforpatientswithearsdisorders.MethodsSpiralCTscanningoftemporalboneswasper-formedwith1.0mmslicethickness,bonealgorithm,9.6cmFOV,and0.1mmreconstructionintervalin34nor-malsubjectsand30(44ears)patientswithdisordersofear.The3DreconstructionandCTvirtualendoscopy(CTVE)ofaudito
5、ryossicularchainweredone.ResultsThirty-fourcases(68ears)werenormaland30pa-tients(44ears)wereabnormalamong64casesscannedwithSCT.Therewerechronicotitismedia(29ears),cholesteatomatypeofchronicotitismedia(3ears),granulomatoustypeofchronicotitismedia(1ear),vestibu-larmalformations(1ear),luxati
6、onoftheincudomallealjoint(1ear),ahighpositionedjugularbulb(2ears),anincompletebonycoveringofahighpositionedjugularbulb(1ear),vestibularaqueductdilate(4ears),co-chlearaqueductdilate(2ears).Oftheabnormalpatients,alltheaxialandMPRimagescoulddisplaythefocusandseverity,andCTVEimagesweresuperio
7、rtotheaxialimagesindisplayingtheauditoryossicularchain.Con-clusionImageofaxialSCTandMPRcanclearlyshowalltheinformationsinthemiddleear.CTVEtechniquecandiplaystereoscopicimageoftheauditoryossicularchain.Thedisadvantagesofvirtualendoscopyarethatthedensitydifferenceofth
