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目的:用多层螺旋CT仿真内镜成像方法显示内耳道底神经管孔的正常解剖及发育异常,并分析各种内耳道底神经管孔发育不全的仿真内镜表现。方法:收集25例(50耳)志愿者高分辨率CT颞骨扫描图像(正常组)和8例(13耳)高分辨率CT和MRI检查示内耳道底发育畸形扫描图像(异常组),用仿真内镜观察内耳道底正常结构及畸形,下限阈值900~1 200 HU,上限阈值3 071 HU。结果:正常组:仿真内镜均显示了50耳各神经管孔的形态和位置。异常组:内耳道底结构紊乱、神经孔缺如9耳,其中内耳道底仅显示单个神经孔1耳;显示2个神经孔4耳,1孔为面神经孔,4个位听神经孔融为1孔;显示3个神经孔2耳,1孔为面神经孔,位听神经孔融为2孔;显示4个神经孔2耳,均为耳蜗神经孔闭锁。单纯神经孔形态异常4耳,均为耳蜗神经孔形态异常,其中非螺旋孔列2耳,蜗轴消失2耳。并发内耳道其他异常3耳。并发内耳畸形8耳。结论:仿真内镜可立体显示各神经孔的形态及位置,显示内耳道底神经管孔发育异常的类型,结合多平面重组(MPR)具有较大的临床应用价值。
OBJECTIVE: To demonstrate the normal anatomy and dysplasia of the medial auditory canal of the internal auditory meatus by multi-slice spiral CT virtual endoscopy and to analyze the simulated endoscopic findings of various medial and ear canal hypoplasia. Methods: Twenty - five (50 ears) volunteers were enrolled in this study. High - resolution CT temporal bone scans (normal group) and 8 cases (13 ears) of high resolution CT and MRI were performed to detect abnormalities of inner ear canal. The endoscopic structures and deformities of the internal auditory canal were observed under simulated endoscopy. The lower threshold was 900-1 200 HU and the upper threshold was 3 071 HU. Results: In the normal group, the simulated endoscope showed the morphology and location of each ear canal in 50 ears. Abnormal group: the structure of the inner ear canal disorder, lack of nerve hole 9 ears, including the inner ear canal only shows a single nerve hole 1 ear; shows 2 nerve holes 4 ears, 1 hole for the facial nerve hole, 4 auditory nerve hole melt 1 Hole; 3 neurovascular 2 ears, 1 hole facial nerve hole, the position of auditory nerve hole melted into 2 holes; 4 nerve holes 2 ears, are cochlear nerve hole atresia. The morphology of pure nerve hole was abnormal, all of them were abnormal morphology of cochlear nerve hole, of which 2 were non-helical and 2 were disappeared. Concomitant internal ear canal other abnormal 3 ears. Concomitant inner ear malformations 8 ears. Conclusion: The simulated endoscope can display the shape and position of each nerve hole stereoscopically, showing the type of neural tube pore dysplasia in the inner ear canal. Combining with multiplanar reconstruction (MPR) has great clinical value.