应用高分辨CT多平面重建分析上半规管裂的影像学特征

陈婷; 梁勇; 张威; 班莫璐; 陈文

doi:10.13201/j.issn.1001-1781.2018.14.010

应用高分辨CT多平面重建分析上半规管裂的影像学特征

- 1. 南方医科大学南方医院耳鼻咽喉头颈外科(广州, 510515);
- 2. 南方医科大学南方医院影像中心

详细信息

通讯作者: 梁勇,E-mail:yliang@smu.edu.cn

中图分类号: R445;R764.3

收稿日期: 2018-04-15

Application of technique of HRCT and multipliate plane reconstruction in analysis of image features of superior semicircular canal dehiscence

- 1. Department of Otolaryngology Head and Neck Surgery, Southern Medical University Nanfang Hospital, Guangzhou, 510515, China;
- 2. Department of Radiology, Southern Medical University Nanfang Hospital

More Information

Corresponding author: LIANG Yong, E-mail: yliang@smu.edu.cn

Received Date: 15 April 2018

摘要

摘要: 目的：应用高分辨CT （HRCT）多平面重建技术，分析可疑上半规管裂综合征病例的影像学表现，以提高对上半规管裂的认识。方法：收集南方医科大学南方医院耳鼻咽喉头颈外科2016-01-2017-04期间230例行颞骨HRCT的成人患者，其中160例（320耳）非上半规管裂，男73例（146耳），女87例（174耳）；年龄18~70岁。70例（113耳）影像学可疑上半规管裂，男33例（55耳），女37例（58耳）；年龄18~71岁。所有研究对象均行颞骨横断位薄层CT扫描，然后用CT后处理工作站行冠状位和斜矢状位多平面重建（MPR）。观察、测量和记录可疑上半规管裂组与非上半规管裂组的影像学特点及其数据，并将收集的数据进行统计学分析。结果：①非上半规管裂组160例（320耳），上半规管高度（6.43±0.51） mm，上半规管外管径（0.83±0.13） mm，鼓室盖厚度（2.19±0.62） mm，乳突前后径（14.55±1.98） mm；可疑上半规管裂组70例（113耳），上半规管高度（6.42±0.60） mm，上半规管管径（0.85±0.16） mm，鼓室盖厚度（1.62±0.55） mm，乳突前后径（13.24±1.97） mm；经统计学分析，上半规管高度（P=0.94）及外管径（P=0.64）差异无统计学意义，鼓室盖厚度（P=0.002）、外耳道后壁乳突前后径（P=0.004）差异有统计学意义。②可疑上半规管裂组70例（113耳）中，单侧缺损者27例（27耳），双侧缺损者43例（86耳）；缺损位于顶壁正中者48耳，位于顶壁前部者20耳，位于顶壁后部者32耳，以上2个部位缺损者13耳；乳突气化型7耳，乳突硬化型90耳，乳突混合型16耳。结论：上半规管裂多发于硬化型乳突，双侧常见，缺损多位于顶壁正中，病变的发生与上半规管的高度及管径无明显相关性，而可能与全颞骨骨质变薄有关，若行耳部手术需予以注意。
- 上半规管裂 /
- 高分辨CT /
- 多平面重建 /
- 颞骨
Abstract: Objective: Application of technique of high resolution CT (HRCT) and multipliate plane reconstruction, analyzed the image features of suspicious superior semicircular canal dehiscence (SSCD) to improve the understanding of the SSCD.Method: From January 2016 to April 2017, a total of 230 adult patients who checked temporal bone HRCT were collected in this retrospective study, of which 160 cases (320 ears) of the non-SSCD, 73 cases were male (146 ears), 87 cases were female (174 ears), aged 18 to 70 years old; 70 cases (113 ears) were suspicious diagnosed with SSCD, 33 cases were male (55 ears), 37 cases were female (58 ears), and 18 to 71 years old. The thin section CT scan of the temporal bone translocation was performed on all subjects, then the CT post processing workstation was used for multipliate plane reconstruction (MPR), and the main rows of coronal and oblique sagittal image reconstruction was performed. To observe, measure and record the HRCT features and datas of the suspicious SSCD and non-SSCD, then analyze the collected data.Result: There were 160 cases (320 ears) in non-SSCD group, and the height of the superior semicircular canal was (6.43±0.51)mm, the outer tube diameter was (0.83±0.13)mm, the thickness of the tympanic cavity was (2.19±0.62)mm, the anteroposterior diameter of mastoid was (14.55±1.98)mm; There were 70 cases (113 ears) in the suspicious SSCD group, the above results were (6.42±0.60)mm, (0.85±0.16)mm, (1.62±0.55)mm, (13.24±1.97)mm, respectively. Statistical analysis showed that there were no significant difference in the height of the superior semicircular canal (P=0.94) and the outer tube diameter (P=0.64), There were significant differences in the thickness of the tympanic cavity (P=0.002) and the anteroposterior diameter of mastoid (P=0.004). There were 70 cases (113 ears) in group suspicious SSCD, the unilateral defect had 27 cases (27 ears), and bilateral defect had 43 cases (86 ears). The defect was located in the middle of the parietal wall in 48 ears, located in the anterior wall of 20 ears, located in the posterior wall of 32 ears, more than two defects in 13 ears; 7 ears were mastoid pneumatic type, 90 ears were mastoid sclerotic type, 16 ears were mastoid mixed type.Conclusion: The SSCD was more common in the sclerotic mastoid. The bilateral defect was common, mostly located in the middle of the parietal wall. The occurrence of the lesion is not related to the height and diameter of the superior semicircular canal, but may be related to the thinning of the whole temporal bone.
- superior semicircular canal dehiscence /
- high resolution CT /
- multipliate plane reconstruction /
- temporal bone

HTML全文

参考文献(19)

[1]	MINOR L B, SOLOMON D, ZINREICH J S, et al.Sound-and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal[J].Arch Otolaryngol Head Neck Surg, 1998, 124:249-258.
[2]	KURT H, ORHAN K, AKSOY S, et al.Evaluation of the superior semicircular canal morphology using cone beam computed tomography:a possible correlation for temporomandibular joint symptoms[J].Oral Surg Oral Med Oral Pathol Oral Radiol, 2014, 117:e280-e288.
[3]	CHEN E Y, PALADIN A, PHILLIPS G, et al.Semicircular canal dehiscence in the pediatric population[J].Int J Pediatr Otorhinolaryngol, 2009, 73:321-327.
[4]	SALIBA I, MANIAKAS A, BENAMIRA L Z, et al.Superior canal dehiscence syndrome:clinical manifestations and radiologic correlations[J].Eur Arch Otorhinolaryngol, 2014, 271:2905-2914.
[5]	CAREY J P, MINOR L B, NAGER G T.Dehiscence or thinning of bone overlying the superior semicircular canal in a temporal bone survey[J].Arch Otolaryngol Head Neck Surg, 2000, 126:137-147.
[6]	TSUNODA A, TERASAKI O.Dehiscence of the bony roof of the superior semicircular canal in the middle cranial fossa[J].J Laryngol Otol, 2002, 116:514-518.
[7]	BELDEN C J, WEG N, MINOR L B, et al.CT evaluation of bone dehiscence of the superior semicircular canal as a cause of sound-and/or pressure-induced vertigo[J].Radiology, 2003, 226:337-343.
[8]	BRANSTETTER B T, HARRIGAL C, ESCOTT E J, et al.Superior semicircular canal dehiscence:oblique reformatted CT images for diagnosis[J].Radiology, 2006, 238:938-942.
[9]	张礼春, 洪汝建, 戴春富, 等.多平面重组技术评价上半规管裂综合征[J].中华耳鼻咽喉头颈外科杂志, 2009, 44(9):736-738.
[10]	HIRVONEN T P, WEG N, ZINREICH S J, et al.High-resolution CT findings suggest a developmental abnormality underlying superior canal dehiscence syndrome[J].Acta Otolaryngol, 2003, 123:477-481.
[11]	MINOR L B, CREMER P D, CAREY J P, et al.Symptoms and signs in superior canal dehiscence syndrome[J].Ann N Y Acad Sci, 2001, 942:259-273.
[12]	GARTRELL B C, GENTRY L R, KENNEDY T A, et al.Radiographic features of superior semicircular canal dehiscence in the setting of chronic ear disease[J].Otol Neurotol, 2014, 35:91-96.
[13]	张礼春, 沙炎, 洪汝建, 等.上半规管裂综合征的多层螺旋CT诊断[J].中华放射学杂志, 2009, 43:1027-1030.
[14]	CHO Y W, SHIM B S, KIM J W, et al.Prevalence of radiologic superior canal dehiscence in normal ears and ears with chronic otitis media[J].Laryngoscope, 2014, 124:746-750.
[15]	SHIM B S, KANG B C, KIM C H, et al.Superior canal dehiscence patients have smaller mastoid volume than age-and sex-matched otosclerosis and temporal bone fracture patients[J].Korean J Audiol, 2012, 16:120-123.
[16]	CLOUTIER J F, BELAIR M, SALIBA I.Superior semicircular canal dehiscence:positive predictive value of high-resolution CT scanning[J].Eur Arch Otorhinolaryngol, 2008, 265:1455-1460.
[17]	李书玲, 刘怀军, 池琛, 等.正常人内耳前庭、半规管及耳蜗的MRI测量[J].中华放射学杂志, 2003, 37(1):55-58.
[18]	PICAVET V, GOVAERE E, FORTON G.Superior semicircular canal dehiscence:prevalence in a population with clinical suspected otosclerosis-type hearing loss[J].B-ENT, 2009, 5:83-88.
[19]	PARK J H, KANG S I, CHOI H S, et al.Thickness of the bony otic capsule:etiopathogenetic perspectives on superior canal dehiscence syndrome[J].Audiol Neurootol, 2015, 20:243-250.