摘要
目的：探讨多层螺旋CT扫描及三维重建技术对人工耳蜗植入术前与术后的评估及其临床价值,并对其与X线摄片方法在植入电极的分布及状态等方面的显示效果进行比较。方法：收集24例行MEDEL Combi40＋型号人工耳蜗植入术的患者,男18例,女6例;年龄2~6岁,平均4岁。24例拟行人工耳蜗植入的患者术前与术后均行多层螺旋CT及三维重建,并于术前运用曲面平展方法测量耳蜗长度,术后均行X线摄片检查,采用侧斜位60°片。结果：24例中,1例通过多层螺旋CT三维重建曲面平展方法于术前测量预测耳蜗长度小于标准电极长度,术后经多层螺旋CT证实其标准电极未能够完全植入耳蜗内,同时发现术后螺旋CT扫描三维重建较传统X线摄片更为直观地显示耳蜗形态、电极状态及植入深度。结论：人工耳蜗植入术术前即应用多层螺旋CT结合曲面平展测量,在显示中耳及内耳结构和立体显示内耳畸形的形态方面明显优于普通CT,对指导手术方案制定及判断预后有着极其重要的临床意义。同时,术后多层螺旋CT扫描三维重建方法观察较数字减影X线成像（DR）更为直观,可更准确帮助预估手术疗效。
Objective：To evaluate the instructional effect of Multi-slice（MSCT） in the cochlear implantation pro-and post-operatively, and to contrast the image feature between the X-ray and the MSCT three-dimensional re- construction of inner ear with implanted electrode. Method：Twenty-four cochlear implant （MEDEL Combi 40＋） recipients,in No. 1 Hospital of China Medical University from January to October 2014, were involved in this study. Among them, 18 were male and 6 female,with an average age of 4 years. MSCT and three dimensional re- construction of inner ear were performed in all of the 24 implanted inner ears pro- and post-operatively. And X-ray plain film were examined by using 60° lateral oblique position postoperatively. All data of the spiral CT scan with axial imm image slices were transferred to workstation for three-dimensional reconstruction （direct volume render- ing） of the inner ear. Result： In 1 of the 24 cases, preoperative three-dimensional reconstruction CT scan reveal that the length of the cochlear was shorter than the electrode. And this was confirmed by MSCT postoperatively that the electrode couldn＇t be inserted by full length. The insertion depth of the electrode can be evaluated directly by MSCT. Moreover, each of the electrode pairs can be identified clearly. Conclusion： MSCT plays an indispensa- ble role in the preoperative evaluation of cochlear implantation. Postoperative evaluation by three-dimensional re- construction of inner ear provide more accurate image to show the electrode insertion depth in the cochlea. MSCT combined with curved planar reformation to measure cochlear length could provide guidance in choosing the more adaptive electrode. And MSCT is superior to DR in demonstration of electrode postoperatively.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2015年第10期878-881,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
耳蜗植入
电极
多层螺旋CT
三维重建
X线
cochlear implantatiom electrode multi-slice CT three-dimensioned reconstruction X-ray
