【摘要】 目的评价听骨链连接关系层面诊断锤砧复合体中断的价值。方法收集经手术证实的锤砧复合体中断患者74例,共85耳,观察锤砧复合体各组成部分及其中断部位在同一个听骨链连接关系层面的显示情况;比较听骨链连接关系层面和轴位图像评价锤砧复合体连续性的差异;分析听骨链连接关系层面诊断锤砧复合体各组成成分连续性中断的敏感度、特异度、Youden指数及观察者间一致性。结果锤骨头、颈、柄,锤砧关节,砧骨体、长脚及其中断部位均可在同一听骨链连接关系层面显示,而砧骨短脚及其中断部位需在多个层面显示。听骨链连接关系层面和轴位图像诊断锤砧复合体连续性中断的阳性数差异无统计学意义(P>0.05)。听骨链连接关系层面诊断锤砧复合体各组成部分连续性中断的敏感度为71.43%～97.06%,特异度为89.47%～100%,诊断砧骨短脚中断Youden指数最低;观察者间一致性较好或极好。结论听骨链连接关系层面可在一个层面上显示锤砧复合体的大部分结构和中断部位,临床应用价值较高。更多还原

【Abstract】 Objective To explore the value of bent-lever plane on detection of malleus-incus complex abnormalities.Methods Totally 85ears in 74patients with malleus-incus complex abnormalities confirmed by surgery were enrolled.The displaying ability of various parts of malleus-incus complex and their abnormality in one single bent-lever plane was observed. The diagnostic ability for malleus-incus complex abnormalities was compared between bent-lever plane and axial images. The diagnostic sensitivity,specificity,Youden index and consistency of two observers for different parts of malleus-incus complex were calculated and compared.Results The head of malleus,neck of malleus,manubrium of malleus,incudomalleolar joint,body of incus and long process of incus of 85ears and their abnormalities could be shown in one single bent-lever plane.The short process of incus and its abnormality needed to be demonstrated in several bent-lever planes.There was no significant difference between bent-lever planes and axial images in identifying abnormalities of malleus-incus complex (P >0.05) .The diagnostic sensitivity of bent-lever plane ranged from 71.43% to 97.06% and specificity ranged from 89.47%to 100%for different parts of malleus-incus complex.Youden index for the short process of the incus was the lowest.The radiologists had perfect or substantial consistency in identifying the abnormalities of different parts of malleus-incus complex.Conclusion Most of segments of malleus-incus complex and their abnormality can be demonstrated in one single bent-lever plane,which has high value of clinical application.更多还原