山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (6): 1-4.doi: 10.6040/j.issn.1673-3770.0.2015.270

• 论著 •    下一篇

MSCT多模态三维重建观测颞骨结构及对人工耳蜗手术的指导意义

王一红1, 李瑞玉1, 陈彩龙2, 王晓燕1, 林美福2, 周硕2   

  1. 1. 福建医科大学省立临床医学院, 福建省立医院, 耳鼻咽喉科, 福建 福州 350001;
    2. 福建医科大学省立临床医学院, 福建省立医院, 核医学科, 福建 福州 350001
  • 收稿日期:2015-06-30 出版日期:2015-12-16 发布日期:2015-12-16
  • 作者简介:王一红. E-mail:entwyh@sina.com

Application of MSCT multimodal 3D reconstruction in the assessment of temporal bone structures and cochlear implantation

WANG Yihong1, LI Ruiyu1, CHEN Cailong2, WANG Xiaoyan1, LIN Meifu2, ZHOU Shuo2   

  1. 1. Department of Otolaryngology, Provincial Clinical Medical College of Fujian Medical University, Fuzhou 350001, Fujian, China;
    2. Department of Nuclear Medicine, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou 350001, Fujian, China
  • Received:2015-06-30 Online:2015-12-16 Published:2015-12-16

摘要: 目的 探讨采用MSCT影像三维多模态重建技术在人工耳蜗植入术术前评估、术后复查中的应用价值.方法 ①应用双阈值重建技术显示耳蜗、前庭、半规管的膜性立体结构及听小骨,颞骨透明成像,逐一融合显示听小骨、内耳与颞骨的关系;②面神经曲面重建显示面神经的走行,观察面神经与面神经隐窝、外耳道后壁、鼓索神经等邻近结构的关系;③双斜径多平面重建(MPR)技术测量鼓岬平面面神经垂直段与鼓索神经的距离.结果 该组83例,内耳畸形11例中Mondini畸形2例、半规管畸形2例、共同腔畸形2例、内听道狭窄1例、前庭导水管扩大4例.正常结构耳鼓岬平面面神经垂直段与鼓索神经距离左侧(0.270±0.057)cm,右侧(0.280±0.068)cm.术后复查5例,清晰显示植入电极位置良好.结论 多模态重建技术能较好地满足临床多角度、全方位观察中耳和内耳解剖的需要,评估手术风险,确保手术顺利进行并可应用于术后复查植入电极的位置.

关键词: 三维多模态重建, 体层摄影术, X线计算机, 多层螺旋CT, 人工耳蜗植入, 颞骨, 面神经

Abstract: Objective To investigate the application and value of MSCT multimodal three-dimensional (3D) reconstruction in cochlear implantation. Methods ① The membranous structures with 3D imaging of cochlea, vestibular, semicircular canal and temporal bone transparent imaging were constructed with a double threshold reconstruction technique, where the anatomical relationship between ossicles, inner ear and temporal bone were displayed. ② The facial nerve reconstruction displayed the path of the facial nerve. The ultrastructure showed the facial nerve, facial nerve recess, posterior wall of the external auditory canal and the structure of chorda tympani nerve and neighboring structures. ③ The distance between promontory plane vertical segment of the facial nerve and chorda tympani nerve was measured. Results Of the 83 patients recruited in this study, 11 had inner ear malformation. Of them, 2 had Mondini malformation, 2 had semicircular canal malformation, 2 had common cavity malformation, 1 had internal auditory canal stenosis, and 4 had enlarged vestibular aqueduct. The distance between normal structure of cape plane vertical segment of the facial nerve and chorda tympani nerve was 0.27±0.057 cm at the left-side and 0.28±0.068 cm at the right-side. An intact structure of the implanted electrodes was clearly showed in 5 patients in the post-operative examination. Conclusion The 3D multimodal reconstruction technique is useful in providing ultrastructure imaging of the middle and inner ear, which is important for surgeons in pre-and post-operative evaluations of the success and potential risk factors for performing cochlear implantation.

Key words: Three dimensional reconstruction of multimode, Cochlear implantation, Tomography, Temporal bone, X-ray computed, Multi-slice spiral CT, Facial nerve

中图分类号: 

  • R764.1
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