摘要
目的研究慢性化脓性中耳炎HRCT表现及临床价值。方法回顾性分析手术证实慢性化脓性中耳炎118耳颞骨横断面、冠状面HRCT,并与手术结果对照。结果胆脂瘤型、骨疡型和单纯型中耳炎HRCT分型诊断的准确率分别为95.8%、94.1%、96.6%,特异性分别为98.4%、96.1%、95.8%,敏感性分别为92.9%、86.7%、97.9%。在鼓室和/乳突窦内有无软组织影,软组织影的形态,面神经管、骨迷路破坏方面,胆脂瘤型、骨疡型中耳炎与单纯型中耳炎之间有显著性差异(P<0.05),而胆脂瘤型中耳炎与骨疡型中耳炎之间无显著性差异(P>0.05)。胆脂瘤型中耳炎破坏听小骨较骨疡型中耳炎常见(P<0.05),单纯型中耳炎均未破坏听小骨。胆脂瘤型中耳炎破坏鼓室盾板、鼓室盖的发生率高于骨疡型和单纯型中耳炎(P<0.05)。胆脂瘤型中耳炎破坏周围骨质边缘硬化高达92.9%,骨疡型中耳炎破坏周围骨质边缘毛糙高达80%。结论HRCT可准确显示中耳腔内软组织灶的分布、形态及听小骨、周围重要结构的破坏情况,在慢性化脓性中耳炎分型诊断及术前评估中有重要价值。
Objective：To study high-resolution Cr（HRCT） findings of chronic suppurative otitis media and evaluate their clinical significance.Methods：HRCT findings of 118 ears with chronic suppurative otitis media confirmed by surgery were analysed retrospectively and compared with surgical findings.Results：The accuracy of HPCT in diagnosis of cholesteatoma, granuloma, and simple otitis media was 95.8%, 94.1%, and 96.6%, respectively. The specificity was 98.4%, 96.1%, and 95.8%, respectively. The sensitivity was 92.9%, 86.7%, and 97.9%, respectively.There is significant difference in location and shape of soft tissue mass, involvement facial nerve canal, tympanic sinus and destruction of bony labyrinth between cholesteatoma, granuloma and simple otitis media, but no difference between cholesteatoma and granuloma. The incidence of destruction of auditory ossicles in cholesteatoma was higher than that in granuloma. No destruction of auditory ossicles was demonstrated in simple otitis media. The incidence of destruction of tympano-scutum or tegmen in cholesteatoma was higher than that in granuloma and simple otitis media. Remodeling of bony wall surrounding the soft tissue mass was found in 52 ears（92.9% ） with cholesteatoma, and bony erosion in 12 ears（80% ） with granuloma. Conclusion： HRCT can accurately show location and shape of soft tissue mass of tympanum and/or mastoid antnnn, destruction of auditory ossicles and important structures of temporal bone, which can provide evidence in diagnosis of choronic suppurative otitis media and in its classification.
出处
《医学影像学杂志》
2007年第2期123-127,共5页
Journal of Medical Imaging
作者简介
刘兆会（1977-），男,吉林省人，医学硕士，医师，主要从事颈部影像学诊断
通讯作者：王振常 首都医科大学附属北京同仁医院 100730
