【摘要】 目的　探讨螺旋CT检查在慢性化脓性中耳炎诊断分型及治疗中的价值。方法　对 65例 79耳慢性化脓性中耳炎行螺旋CT检查 ,将轴位HRCT、冠状位MPR及听骨链 3D重建图像与手术结果对比分析。结果　轴位HRCT、冠状位MPR图像对慢性化脓性中耳炎诊断分型能力基本相同 ,但对中耳细微结构的显示有一定差异。 3DCT对锤、砧骨破坏的显示能力优于轴位HRCT及冠状位MPR图像 ,对蹬骨细微结构的显示则较后两者差 ,3DCT不能单独用于中耳炎的诊断分型 ,需与 2DCT图像结合 ,三者结合对中耳炎诊断分型与手术结果比较符合率高 (89.9%～ 97.5 % ) ,误诊率 (2 .9%～ 6.0 % )及漏诊率 (0～ 14 .6% )低。结论　螺旋CT 3种图像相结合有助于慢性化脓性中耳炎诊断分型及手术方案的制定。更多还原

【Abstract】 Objective To evalute the value of spiral CT in diagnosis and treatment of chronic suppurative otitis media.Methods Sixty-five cases including seventy-nine ears underwent the direct axial plane and coronal multiplanar reformation and three-dimensional reconstruction of auditory ossicular chain in chronic suppurative otitis media spiral CT imaging of temporal bone. Results The direct axial plane and coronal multiplanar reformation in diagnosing of the chronic suppurativeotitis media were correspondent,but in showing of the most middle ear structure were difference. Three-dimensional images was superior to axial and coronal MPR images in showing of the change of malleus and incus,the contrary situation in showing stapes. Only 3D image may not select application for definition.The rate of agreement between spiral CT diagnosis by combination of three different imaging methods and definition of chronic suppurative otitis media and operative findings(89.9%～97.5%) were higher, false positive rate(2.9%～6.0%) and false negative rate(0～14.6%) of the CT diagnosis were lower.Conclusion Combination of three different imaging methods(axial images, coronal MPR images and three-dimensional images of the ossicular chain) can improve the value of the spiral CT diagnosis and therapy of chronic otitis media.更多还原