【摘要】 目的　探讨镫骨螺旋CT多平面重组 (multi planarreformation ,MPR)在术前诊断中的作用以及对手术选择的影响。方法　正常组 5 0例 (10 0耳 )无耳症状、体征的志愿者和异常组镫骨异常者10 2例 (137耳 )全部行平行枕眶线扫描 ,应用轴位图像行多方位的MPR。比较轴位、冠状位、矢状位和镫骨斜位MPR图像整体显示镫骨的形态和结构情况。在镫骨斜位MPR图像上测量镫骨的高度。异常组行听骨链重建术 5 7例 (6 4耳 ) ,术中观察镫骨的结构、形态和破坏情况 ,并与MPRCT图像比较。结果　正常组轴位、冠状位、矢状位MPR图像均未能显示镫骨的整体形态 ,镫骨斜位MPR图像均直观显示了镫骨的整体形态和结构。在镫骨斜位MPR图像上 ,测量镫骨高度为 (3 3± 0 4 )mm。异常组10 2例 ,轴位、冠状位、矢状位MPR图像均不能显示镫骨的破坏情况和结构异常 ,斜位MPR镫骨图像均直观显示了镫骨的破坏情况和结构异常。慢性中耳炎合并镫骨破坏 6 9例 (90耳 ) ;先天性镫骨异常33例 (4 7耳 ) ,其中砧骨镫骨分离 5例 (7耳 ) ,镫骨头及足弓完全缺如 9例 (13耳 ) ,镫骨足弓不完整 ,1侧足弓缺如 3例 (4耳 ) ,镫骨底板增厚与周围骨融合 16例 (2 3耳 )。与术中所见对照 ,镫骨斜位MPR图像显示镫骨结构、形态异常的符合率为 95 3%。结论　镫骨异?更多还原

【Abstract】 Objective To evaluate the clinical application of multi-planar reformation (MPR) for the stapes with multi-slice spinal thin-section CT in the patients with disorder of stapes before prosthetic ossicular reconstruction and their impact on surgical decision. Methods Axial CT scanning of temporal bone was undergone in 50 volunteers. Multiplan reformatted images included coronal, sagittal and oblique MPR, were made. All the MPR images were compared with each other in order to show which one could reveal the whole structures of stapes better. The height of stapes was measured with the oblique MPR. CT findings were evaluated in 102 cases with disorder of stapes. Prosthetic ossicular reconstruction was made in 65 cases. Results The full stapes cannot be shown in axial, coronal and sagittal MPR images, however, it was shown in oblique MPR in all the cases. The highness of stapes was (3.3 ±0.4) mm in the abnormal group. There was chronic otitis media in 69 cases (90 ears) and congenital abnormalities of the stapes in 33 cases (47 ears) which included the dispart of incudostapedial joint in 5 cases (7 ears), defect of head and crus of stapes in 9 cases (13 ears), defect of one side of crus in 3 cases (4 ears) and absence of the oval window in 16 cases (23 ears). Conclusions Coronal and oblique MPR images from Axial Spiral CT Data are essential for the pre-operative planning of prosthetic ossicular reconstruction. The ship, structure or defect of stapes can be shown in the oblique MPR images. It is important for the patient to choose the type of operation.更多还原