CT仿真内镜在诊断骨性蜗神经管发育不良中的初步应用.pdf

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1、床放射学杂志2013年第32卷第8期·1083·头颈部放射学CT仿真内镜在诊断骨性蜗神经管发育不良中的初步应用全勇，巩若箴，武乐斌，樊兆民，李建峰【摘要】目的回顾性评价螺旋状结构消失作为cT仿真内镜诊断骨性蜗神经管发育不良的可行性。方法病例组包括14例(20耳)骨性蜗神经管发育不良者，对照组由无内耳及内听道疾患的50例(100耳)受试者组成。以临床及常规影像诊断结果作为骨性蜗神经管发育不良的诊断标准。仿真内镜观察骨性蜗神经管采用Flythrough技术并使用如下阈值：下限阈值850～1150，上限阈值3071。阳性结果指螺旋状结构或中央管消失；阴性结果指螺

2、旋状结构或中央管存在。分别计算敏感性、特异性、准确性。结果病例组中17耳未显示螺旋状结构，3耳显示螺旋状结构，对照组中均显示螺旋状结构。观察者间有大量一致性(K=0．773)。以螺旋状结构消失作为征象诊断骨性蜗神经管发育不良的敏感性、特异性、准确性分别为85％、100％、98％。螺旋状结构消失在病例组及对照组之间有明显的统计学差异。结论螺旋状结构消失可以作为诊断骨性蜗神经管发育不良的有用征象。【关键词】骨性蜗神经管体层摄影术，x线计算机仿真内镜DetectionofHypoplasiaofBonyCochlearNerveCanalByVirtualEnd

3、oscopy：APrilimitaryStudyQUANYong，GONGRuozhen，wuLebin，eta1．DepartmentofRadiology，ShanxianCentralHospital，AfiliatedwithJiningMedicalCollege，Shanxian，ShandongProvince274300，P．R．China【Abstract】ObjectiveToretrospectivelyexaminethefeasibilityofcomputedtomographic(CT)virtualendoscopy(VE)

4、intheevaluationofhypoplasiaofbonycochlearnervecanal(BCNC)baseonabsenceofhelixlikeshape．MethodsTwentyearsin14consecutivepatientsdiagnosedwithBCNChypoplasiaand100earsin50gender·andage·-matchedin-dividualswithoutinnereardiseaseandinternalauditorycanalmalformationswereincludedinthiswo

5、rk．TheBCNCsofallsubjectswerereconstructedusing3Dsoftwareprogram(FlyThrough，3D)．TheVEwasperformedapplyinglowthresholdof850HUto1150HUandhighthresholdof3071HU．HypoplasiaBCNCwasdefinedasabsenceofhelix—likeshapeorcentralcanalofthecochleaonCTVE．NormalresuhonCTVEwasdefinedaspresenceofhel

6、ix—likeshapeorcentralcanalofthecochlea．Sensitivity，specificityandaccuracyofCTVEwerecalculated．Results17of20earsofhypoplasiaBCNCshowedabsenceofhelixlikeshapeonCTVE．AlloftheearsofcontrolsubjectsshowedhelixlikeshapeandcentralcanalofthecochleaonCTVE．Inter—observeragreementwassubstanti

7、al(K=0．773)．TheBCNChypoplasiawasdiagnosedbasedonabsenceofhelix-likeshape，thesensitivity，specificityandaccuracywere85％，100％and98％respectively．Thereweresignificantdifferencesofabsenceofhelix—likeshapebetweenthetwogroups(P<0．001)．ConclusionTheabsenceofhelix—likeshapeonCTVEimagesmaybe

8、usedasapotentiallyusefulsignfordi