Research of cochlear coiling pattern and orientation in general population by CT 3D reconstruction
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摘要: 目的：运用CT三维重建等影像手段对正常人群耳蜗进行形态学研究，为指导内耳畸形的诊断及人工耳蜗植入等内耳手术的术前评估提供理论依据。方法：收集100例（200耳）排除内耳解剖异常的患者作为研究对象，依年龄分为5组，利用计算机工作站的3D立体重建和2D多平面重建技术对其耳蜗基底部的长和宽、底周内最长直线距离、耳蜗的高度、第一周和第二周之间的角度及正中矢状面与底周间夹角等结构进行系统测量，统计分析以上各结构指标在不同年龄组、性别、左右耳之间的差异。结果：耳蜗基底部的长为（8.56±0.52）mm、宽为（6.63±0.56）mm、底周内最长直线距离为（7.33±0.56）mm、耳蜗的高度为（3.76±0.28）mm、第一周和第二周之间的角度为（15.82±2.78）°。以上所有指标在不同年龄、性别及左右耳间差异无统计学意义（P>0.05）。正中矢状面与耳蜗底周间角度在各年龄组间差异有统计学意义，该角度随着年龄的增长而缩小（P<0.05）。第一和第二周之间的角度在各年龄组内存在变异，提示耳蜗的盘曲模式在个体间差异明显。结论：3D和2D多平面重建技术能准确评价内耳形态结构，测定国人耳蜗各主要结构的正常值，可为临床诊断及人工耳蜗等内耳手术治疗提供重要的参考依据。Abstract: Objective: To perform morphometric analysis of bilateral cochleae in all subjects based on computed 3-dimensional reconstruction tomographic data and assist the surgeon in diagnosing the inner ear abnormality or surgical strategies. Method: Two hundred normal developed cochleae from 100 patients were divided into 5 groups according to age. Morphometric analysis of bilateral cochleae was performed in all subjects by 3D reconstructions and 2D multiplanar reformation. The length and width of the cochlear base, the length within the cochlear base, the height of the cochlea, the angle between the first and second turn of the cochlea, and the cochlear orientation within the cranial base were measured and compared in different age, sex and bilateral groups. Result: The length of the cochlear base was (8.56±0.52)mm, the width was (6.63±0.56)mm, the length within the cochlear base was (7.33±0.56)mm, the height of the cochlea was (3.76±0.28)mm,and the angle between the first and second turn of the cochlea was (15.82±2.78)°. All index above did not change significantly in different aging, sex or side(P>0.05). Variability in the angle between the first and second turn of the cochlea was considerable, and a smaller angle (from the midsagittal line) was showed in the older age groups than the younger groups(P<0.05). Conclusion: 3D and 2D volume rendering enables us to evaluate the features of cochlear morphology and orientation that may assist the surgeon in diagnosing the inner ear abnormality or surgical strategies.
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