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目的评价容积再现技术(VRT)对正常内耳及内耳病变的显示能力。方法对20例(40耳)正常内耳及42例(61耳)内耳病变患者行多层螺旋CT横断面扫描,扫描参数为120kV,100mAs,0.75mm准直器宽度,螺距为1,高分辨骨算法重建。对感兴趣耳进行VRT重建。结果VRT图像清晰显示了正常内耳的空间立体结构。40耳先天性内耳发育畸形VRT图像均立体、直观、清晰地显示了畸形的形态和部位。VRT表现为:(1)Michel畸形1耳:内耳完全缺如;(2)共同腔畸形3耳:耳蜗与前庭不能相互区分,呈一囊状结构;(3)不完全分隔Ⅰ型3耳:耳蜗呈囊状,前庭扩大呈囊状,二者可相互区分;(4)不完全分隔Ⅱ型(即Mondini型)5耳:耳蜗仅1.5圈,中圈和顶圈融合,前庭扩大;(5)前庭与半规管畸形14耳:耳蜗正常,前庭扩大,半规管短小、缺如或扩大;(6)前庭导水管扩大14耳:前庭导水管开口扩大呈喇叭口状,与总脚相通。骨化性迷路炎患者7例(7耳),4耳重组时不能完整地显示内耳的立体结构,3耳表现为耳蜗变细或半规管显示不完整。14例(14耳)迷路瘘管患者中,耳蜗破坏1耳,耳蜗、前庭、水平半规管、上半规管均破坏3耳,仅水平半规管破坏10耳。VRT图像表现为半规管或耳蜗与团状高密度结构相连,重组时不能相互分开。结论VRT可清晰显示正常内耳及部分内耳病变,对内耳病变的诊断有重要帮助。
Objective To evaluate the ability of volume rendering (VRT) to show the normal inner ear and inner ear lesions. Methods Twenty patients (40 ears) with normal inner ear and 42 cases (61 ears) with inner ear lesion underwent multi-slice spiral CT scan. The scanning parameters were 120kV, 100mAs, 0.75mm collimator width, pitch 1, high resolution bone Algorithm reconstruction. VRT reconstruction of the ear of interest. Results The VRT image clearly shows the spatial three-dimensional structure of the normal inner ear. 40 ears of congenital inner ear malformations VRT images are stereoscopic, intuitive, clearly shows the deformity of the shape and location. VRT showed as follows: (1) Michel deformity 1 ear: complete absence of the inner ear; (2) common cavity deformity 3 ears: the cochlea and vestibule can not be distinguished from each other, showing a cystic structure; (3) The cochlea is cystic and vestibular enlargement is cystic, the two can be distinguished from each other. (4) Five types of ear (type Mondini) are not completely separated: the cochlea is only 1.5 laps, the middle ring and the top ring are fused, ) Vestibular and semicircular canal deformity 14 ears: cochlea normal, vestibular enlargement, semicircular canal short, missing or expanded; (6) vestibular aqueduct enlargement 14 ears: vestibular aqueduct enlargement was bell-shaped, with the total pin phase. 7 cases (7 ears) of patients with ossification labyrinth were not able to completely display the inner structure of the inner ear when 4 ears were reorganized, 3 ears showed cochlear thinning or incomplete semicircular canal display. In 14 patients (14 ears) with fistula, the cochlea damaged 1 ear, cochlea, vestibule, horizontal semicircular canal and upper semicircular canal all destroyed 3 ears, and horizontal semicircular canal destroyed 10 ears only. VRT images showed semicircular canal or cochlea and clumpy high-density structure connected, recombination can not be separated from each other. Conclusion VRT can clearly show the normal inner ear and some inner ear lesions, and it is helpful to the diagnosis of inner ear lesions.