The Diagnostic Value of HRCT Image Reconstruction and Post-processing Technology in Chronic Suppurative Otitis Media and Middle Ear Cholesteatoma

LI Biqiang; WANG Xiaoming; HUANG Xianlong; LI Chaojun; YANG Chao; TANG Zhuoyue; TANG Yongcun

doi:10.3969/j.issn.1672-2922.2015.02.026

Abstract：Objective To investigate the high resolution CT(HRCT) conventional axial scanning, coronal reconstruction images and image post-processing technology in the diagnosis of chronic suppurative otitis media(CSOM ) and middle ear choles?teatoma. Methods 107 ears(105 patients) were included who had been diagnosed CSOM or middle ear cholesteatoma by surgi?cal pathology, and been checked by 64 slices spiral CT volume scanning before surgery. The retrospectively analysis was applied to compare the positive rate of CT diagnostic results with surgery’s. The CT diagnostic results were classification into the follow?ing three cases:1. The soft tissue density shadows in tympanic cavity and drum sinus cavity. 2. The bone damage of auditory ossi?cle chain. 3. The bone destruction of tympanic cavity and drum sinus wall, according to the conventional axial scanning, coronal reconstruction images and image post-processing technology. Results The accurate rate of MSCT diagnostic results was 89%in 107 ears, including 48 middle ear cholesteatoma and 59 chronic suppurative otitis media (8 simple type, 36 granulation type, 15 sclerotic and granulation mixed type). For three main CT signs, The positive rate of the CT conventional axial scanning and coronal reconstruction images were 88%, but it up to 95%if combined with the image post-processing technology. It was indicat?ed that multi-plane reformation (MPR) could be used to show all of the positive findings of surgery which could be showed with CT scanning, and that the volume rendering(VR)and the multi-plane volume rendering(MPVR)were good at showing the dam?age of malleus and incus, but were restricted at showing the damage of stapes. It was showed that the curve plane reforma?tion(CPR) could be satisfied at showing the bone destruction of facial nerve bone tube, and had the value in showing the bone de?struction of auditory ossicle chain. Conclusions It was concluded that MSCT preoperative classification for chronic otitis media was accurately,HRCT conventional axial scanning and coronal reconstruction images could be used to show the anatomic struc? tures of ear, the lesion of CSOM and middle ear cholesteatoma comprehensively and accurately. It was confirmed that all of the image post-processing technology especially MPR, could improve the detection rate of small lesions and the accuracy of diag?nosis of CSOM and middle ear cholesteatoma, and had great application value in clinical.