摘要
目的:通过对中耳炎患者听骨链病变术前颞骨HRCT诊断与术中诊断符合率的对比分析,探讨中耳乳突手术患者术前HRCT对判断听骨链病变的价值。方法:48例50耳颞骨影像学和临床资料完整的慢性化脓性中耳炎住院患者,已行中耳乳突手术,对其术前HRCT诊断与术中所见进行回顾性分析,比较听骨链病变术前HRCT检查与术中所见的符合情况,探讨HRCT对中耳炎患者听骨链病变诊断的准确性。结果:HRCT对病变听骨链的诊断准确率与术中对照符合率较高,砧骨的Kappa值达0.8286,超过0.75,显示HRCT对砧骨病变的显示与术中所见一致性非常好。锤骨、镫骨上部结构、锤砧关节和砧镫关节的Kappa值均超过0.40,显示HRCT对上述病变诊断的一致性较好。结论:通过不同重建方法,术前HRCT能对听骨链病变程度做出准确判断,有助于术者在术前对手术的径路和方式的选择,并能对手术安全性及手术预后的评估提供参考依据。
Objective： To explore the diagnostic value of HRCT in the detection of lesions in the temporal bone and ossicular chain, by comparing the coincident rate between temporal bone HRCT diagnosis with operation. Methods： This retrospective study included 50 ears of 48 chronic suppurative otitis media patient that have complete clinical and CT data, HRCT features were correlated with surgical operation to explore the accuracy of HRCT in detecting ossicular chain in otitis patient. Result： HRCT had good coincident rate of ossieular chain with surgical operation, incus Kappa value is 0.8286, more than 0.75, indicated that HRCT had excellent coincident rate with surgical diagnosis. Kappa values of malleus, upper structure of stapes, ineudomalleolar joint and ineudostapedial joint are more than 0.40, indicated good coincidence between HRCT and surgical diagnosis. Conclusion： Temporal bone HRCT before operation can make accurate judgment of ossicular chain pathological change by use of different reconstruction methods, which help to do accurate judgment of ossicular change, have benefit to the choice of surgical pathway and method, and help to assess the surgical risk and prognosis.
出处
《中国临床医学影像杂志》
CAS
北大核心
2009年第7期509-511,共3页
Journal of China Clinic Medical Imaging
基金
广州市科技局科技攻关计划科技攻关项目基金(2006Z3-E0311)
