张宏,邬小平,银小辉,杨想春,马鸣岳.颞部HRCT多平面重组及曲面重组诊断先天性小耳畸形[J].中国医学影像技术,2021,37(7):993~997
颞部HRCT多平面重组及曲面重组诊断先天性小耳畸形
Temporal high resolution CT multiplanar reformation and curved planar reformation for diagnosis of congenital microtia
投稿时间:2020-06-28  修订日期:2021-04-19
DOI:10.13929/j.issn.1003-3289.2021.07.007
中文关键词:  先天性小耳畸形  诊断  体层摄影术,X线计算机
英文关键词:congenital microtia  diagnosis  tomography, X-ray computed
基金项目:陕西省重点研发计划项目(2020SF-139)。
作者单位E-mail
张宏 西安交通大学附属西安市中心医院放射科, 陕西 西安 710003  
邬小平 西安交通大学附属西安市中心医院放射科, 陕西 西安 710003  
银小辉 西安交通大学附属西安市中心医院放射科, 陕西 西安 710003  
杨想春 西安交通大学附属西安市中心医院放射科, 陕西 西安 710003  
马鸣岳 西安交通大学附属西安市中心医院放射科, 陕西 西安 710003 mmy_2005@163.com 
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中文摘要:
      目的 观察先天性小耳畸形颞部高分辨率CT(HRCT)多平面重组(MPR)及曲面重组(CPR)表现。方法 对61例临床诊断先天性小耳畸形(69耳)患者颞部HRCT行MPR及CPR,观察其表现。结果 69患耳中,53耳外耳道骨性闭锁(53/69,76.81%),66耳(66/69,95.65%)锤骨畸形,55耳(55/69,79.71%)砧骨畸形,27耳(27/69,39.13%)镫骨畸形。60耳(60/69,86.96%)见不同程度面神经管(FNC)畸形,包括17耳(17/60,28.33%)FNC位于鼓室段低位,其中14例单侧小耳畸形FNC鼓室段低位,患侧FNC鼓室段上缘与水平半规管内端垂直距离[1.40(1.20,1.50)mm]大于对侧[0.80(0.60,0.80)mm,Z=-4.533,P=0.001]。57耳(57/60,95.00%)FNC乳突段前位,其中45例单侧小耳畸形FNC乳突段前位,患侧FNC乳突段中点至膝状神经窝前缘连线的垂直距离[7.10(5.70,8.50)mm]小于对侧[11.00(10.00,12.10)mm,Z=-7.531,P=0.001];2耳(2/60,3.33%)FNC迷路段-乳突段缺如;1耳(1/60,1.67%)FNC鼓室段-乳突段缺如;5耳(5/60,8.33%)见FNC鼓室段裂缺,3耳(3/60,5.00%)FNC明显纤细,7耳(7/60,11.67%)见FNC乳突段分叉畸形。结论 颞部HRCT及MPR、CPR能清晰显示先天性小耳畸形外耳道、各听小骨、听骨链及FNC畸形,具有一定诊断价值。
英文摘要:
      Objective To observe the manifestations of congenital microtia on multiplanar reformation (MPR) and curved planar reformation (CPR) of temporal high resolution CT (HRCT). Methods MPR and CPR of temporal HRCT of 61 patients with congenital microtia (69 ears) were performed, and the CT manifestations were observed. Results Among 69 affected ears, osseous atresia of external auditory canal was common (53/69, 76.81%). Malleus malformation was observed in 66 ears (66/69, 95.65%), incus malformation in 55 ears (55/69, 79.71%) and stapes malformation in 27 ears (27/69, 39.13%). Totally 60 ears (60/69, 86.96%) showed different degrees of facial nerve canal (FNC) deformities, including 17 ears (17/60, 28.33%) of FNC low tympanic segment. Among 14 cases of unilateral microtia with FNC low tympanic segment, the vertical distance between the upper edge of tympanic segment of FNC to the horizontal semicircular canal of the affected side (1.40 [1.20, 1.50]mm) was longer than that of the contralateral side (0.80 [0.60, 0.80] mm, Z=-4.533, P=0.001). Totally 57 ears (57/60, 95.00%) had mastoid segment anteposition, including 45 cases of unilateral microtia with FNC mastoid segment anteposition, and the vertical distance from the middle point of the mastoid segment of FNC to the anterior edge of geniculate ganglion of the affected side (7.10 [5.70, 8.50]mm) was shorter than that of the contralateral side (11.00 [10.00, 12.10]mm, Z=-7.531, P=0.001). The labyrinthine and mastoid segments of FNC were absent in 2 ears (2/60, 3.33%), and FNC was found lacked of tympano-mastoid segment in 1 ear (1/60, 1.67%),while fissure of tympanic segment of FNC was observed in 5 ears (5/60, 8.33%), obvious slender of FNC in 3 ears(3/60, 5.00%) and bifurcation of mastoid segment of FNC in 7 ears (7/60, 11.67%). Conclusion MPR and CPR of temporal HRCT could clearly show the deformities of external auditory canal, ossicles, ossicle chain and FNC of congenital microtia, therefore having certain diagnostic values.
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