摘要
目的 观察MSCT显示先天性中耳畸形(CMEM)患者面神经管(FNC)鼓室段走行异常的价值。方法 回顾性分析94例CMEM患者(CMEM组,包括63例单侧及31例双侧受累,共125侧)及98例非CMEM患者(对照组,191侧)颞骨上缘至乳突下缘轴位CT图像,根据CT表现将CMEM分为3型。于MSCT多平面重建(MPR)冠状位前庭窗(OW)正中层面图像中测量FNC鼓室段与外骨半规管(LSC)下缘间距离(FNC-LSC)、FNC鼓室段与OW外缘(FNC-OW)之间的垂直距离,以定位FNC鼓室段走行;比较FNC鼓室段走行在不同范围、类型CMEM患者中的差异。结果 CMEM组FNC-LSC距离大于、而FNC-OW距离小于对照组(P均<0.05)。双侧CMEM患者FNC-LSC距离最大,单侧CMEM患者次之,对照组最小,差异均有统计学意义(P均<0.05);双侧CMEM患者FNC-OW距离最小,单侧CMEM患者次之,对照组最大,差异均有统计学意义(P均<0.05)。CMEM组125侧中,CMEMⅠ型18侧,Ⅱ型45侧,Ⅲ型62侧;Ⅲ型FNC-LSC距离最大,Ⅱ型次之,Ⅰ型再次之,对照组最小;除Ⅰ型与对照组差异无统计学意义外,其余两两比较差异均有统计学意义(P均<0.05)。Ⅲ型FNC-OW距离最小,Ⅱ型次之,Ⅰ型再次之,对照组最大;Ⅲ型FNC-OW距离明显小于Ⅱ型、Ⅰ型及对照组(P均<0.05),其余两两比较差异均无统计学意义(P均>0.05)。结论 CMEM常伴FNC鼓室段走行异常;根据冠状位MSCT MPR图像可准确判断FNC鼓室段移位及其程度,有利于术前风险评估。
Objective To explore the value of multi-slice spiral CT(MSCT) for displaying abnormal course of tympanic segment of facial nerve canal(FNC) in patients with congenital middle ear malformation(CMEM). Methods Axial CT images of 94 CMEM patients(CMEM group, 125 sides, including 63 cases of bilateral and 31 cases of unilateral involvement) and 98 non-CMEM patients(control group, 191 sides) from the upper edge of the temporal bone to the lower edge of the mastoid process were retrospectively analyzed. CMEM was classified into 3 types according to CT findings. The distance between FNC tympanic segment and the lower edge of the lateral semicircular canal(LSC)(FNC-LSC), and the vertical distance between FNC tympanic segment and the outer edge of the oval window(FNC-OW) were measured at the median plane of the coronal oval window(OW) of MSCT multi-planar reformation(MPR) to locate FNC tympanic segment. FNC tympanic segments were compared among CMEM patients with different ranges and types. Results In CMEM group, FNC-LSC distance was longer, while FNC-OW distance was shorter than those in control group(both P<0.05). FNC-LSC distance was the longest in bilateral CMEM patients, followed by unilateral CMEM patients, and was the shortest in control group, all differences were significant(all P<0.05). FNC-OW distance was the shortest in bilateral CMEM patients, followed by unilateral CMEM patients, and was the longest in control group(all P<0.05). Among 125 sides in CMEM group, there were 18 sides of type Ⅰ, 45 sides of type Ⅱ and 62 sides of type Ⅲ CMEM. FNC-LSC distance was the longest in patients with type Ⅲ CMEM, followed by type Ⅱ and type Ⅰ, and was the shortest in control group. Significant differences FNC-LSC distance were found between CMEM types and control group(all P<0.05), except between type ⅠCMEM patients and control group. FNC-OW distance was the shortest in type Ⅲ CMEM patients, followed by type Ⅱ and type Ⅰ, and was the longest in control group. FNC-OW distance in type Ⅲ CMEM patient was significantly shorter than that of type Ⅱ, Ⅰ and control group(all P<0.05), while no significant difference was found between each other two(all P>0.05). Conclusion CMEM often complicated with abnormal course of FNC tympanic segment. Coronal MSCT MPR images could be used to accurately judge the displacement and severity of abnormal course of FNC tympanic segment for predicting the risk before surgery.
作者
韩蕾
董季平
邬小平
马鸣岳
赵芸芸
孙鹏峰
刘红生
HAN Lei;DONG Jiping;WU Xiaoping;MA Mingyue;ZHAO Yunyun;SUN Pengfeng;LIU Hongsheng(Department of Radiology,Xi'an Central Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710003,China)
出处
《中国医学影像技术》
CSCD
北大核心
2022年第11期1626-1630,共5页
Chinese Journal of Medical Imaging Technology
基金
陕西省重点研发计划(2020SF-139)。
