摘要：
目的 探讨HRCT与MRI综合影像诊断在中耳乳突炎术前评估中的应用价值.方法 回顾性分析100例中耳乳突炎患者影像资料,男63例,女37例,年龄2～76岁,所有患者均行HRCT及MRI(T1WI、T2WI、3D-FIESTA)检查.回顾分析HRCT、MRI、HRCT+MRI 3种影像检查方式对中耳乳突炎直接征象、间接征象(听骨链破坏、鼓室壁破坏、颅内侵犯等)的显示情况,分别记录数据并统计分析3种影像学检查方式对中耳乳突炎直接征象及间接征象显示方面有无差异.结果 经统计分析,对100例中耳乳突炎的直接征象显示:P＞ 0.05,按照a=0.05标准检验,认为三组检查方式之间差异无统计学意义;对间接征象显示:P＜ 0.001,按照a=0.05标准检验,认为3种检查方式之间差异有统计学意义.本组观察对象HRCT、MRI、HRCT+MRI对间接征象的显示率分别56％、15％、64％,其中对间接征象的显示率HRCT+MRI检查方式优于HRCT及MRI检查方式.结论 中耳乳突炎患者综合应用HRCT与MRI检查,能提高其间接征象的检出率,尤其对于拟手术患者,术前明确中耳炎周围侵犯状况尤其重要.%Objective To investigate the value of HRCT combining MRI in the preoperative evaluation of middle ear mastoiditis.Methods The CT images of 100 patients with middle ear cholesteatoma were retrospectively analyzed.Among the 100 patients,63 were male and 37 female.They were 2 to 76 years old.All the patients were examined by HRCT and MRI (T1WI,T2WI,and 3D-FIESTA).The direct and indirect signs of middle ear mastoiditis (auditory chain destruction,tympanic wall destruction,and intracranial invasion) by HRCT,MRI,and HRCT+MRI were retrospectively analyzed.All the data were recorded and analyzed statistically to find the differences among the 3 methods.Results According to the statistical analysis,there were no statistical differences in the direct signs among the 3 groups (P ＞ 0.05),but were in the indirect signs (P ＜ 0.001).The display rates of indirect signs by HRCT,MRI,and HRCT+MRI were 56％,15％,and 64％.The display rate of indirect signs by HRCT+MRI was better than those by HRCT and MRI.Conclusion The combination of HRCT with MRI can improve the detection rate of indirect signs in patients with middle ear mastoiditis.Especially for the patients undergoing surgery,it is particularly important to determine the surrounding structure invasion of otitis media before operation.
