摘要
目的：利用多种后处理重建方法显示人工耳蜗电极以及计数植入电极，对电极显示清晰度进行评分，探讨256层螺旋CT人工耳蜗植入术后影像学评估的作用。材料与方法：回顾性分析了在我院行人工耳蜗植入术术后进行颞骨HRCT检查的患儿共计15例。扫描仪采用飞利浦256层Brilliance iCT，后处理工作站为EBW，采用螺旋扫描模式。对人工耳蜗植入侧进行回顾性小视野重建，FOV为9 cm。采用Y-sharp（C）图像序列分别做垂直及平行于蜗轴轴位的斜冠状面及斜矢状面的MPR图像；采用Smooth（A）图像序列做VRT图像。在斜冠状面及斜矢状面MPR图像上进行电极显示清晰度的评估并进行电极计数。计算两位医生对电极显示清晰度评分的一致性，将CT图像电极计数与手术记录植入的电极数进行配对t检验。结果：两位医生对于电极显示清晰度的评价没有差别，一致性良好，t值为2.092，P=0.055>0.05。将CT图像中电极计数与术中记录的电极个数进行配对t检验，t值1.468，P=0.164>0.05。结论：结合横断面及多种后处理重建方法，256层螺旋CT可直观观察植入电极的形态及位置，准确评估电极在耳蜗内植入的数目，有重要的临床价值。
Abstract
Objective: Postoperative imaging of cochlear implants needs to provide detailed information on localization, insertion depth and visualization of the electrode array. We evaluated these information with 256-slice CT and several processing techniques. Materials and Methods: The clinical histories and CT studies of 15 children with cochlear implants were retrospectively analyzed. Images in this thesis were acquired from 256-slice Brillance iCT(Philips Healthcare) scanner with helical mode. Then we reconstructed two image sequences of the interesting temporal with a small FOV(9 cm) using a high resolution reconstruction algorithm and low resolution reconstruction algorithm respectively. Multi-planar reformations perpendicular and parallel to the modiolar axis were made with contiguous 0.2 mm sections. The volume rendering was made with the image sequence of low resolution reconstruction algorithm. On oblique coronal and oblique saggital reformation images, we evaluate the information of cochlear implants on the precise localization of the implant and its individual contacts as well as the visibility of electrode array. Additionally the number of the electrode array was counted and compared with the surgical recording. On a multi-planar reformation perpendicular to the modiolus axial image, we evaluate the visibility of electrode array. The image was evaluated by 2 head and neck radiologists using a 2-point scale. Results: The interobserver agreement for the visibility of electrodes was very high, t=2.092, P=0.055>0.05. Axial CT and multi-planar reformation images can provide the inserted electrode number and had no significant difference between surgical recording, t=1.468, P=0.164>0.05. Conclusion: Postoperative CT of cochlear implants should provide information on the precise localization of the implant and its individual electrode. And on the multi-planar reformation perpendicular and parallel to the modiolus axis, the number of the implanted electrodes can be evaluated. The volume rendering technique can give a outlook of totality of the implants.
关键词
耳蜗植入术 /
体层摄影术 /
螺旋计算机
Key words
Cochlear implantation /
Tomography /
spiral computed
郑 慧;李玉华;李惠民;刘 明;曹雯君;汪登斌.
人工耳蜗植入术后CT评估[J]. 中国临床医学影像杂志. 2014, 25(1): 9-12
ZHENG Hui;LI Yu-hua;LI Hui-min;LIU Ming;CAO Wen-jun;WANG Deng-bin.
Evaluation of CT in postoperative imaging of pediatric cochlear implants[J]. Journal of China Clinic Medical Imaging. 2014, 25(1): 9-12
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