摘要
目的 讨论在耳硬化症的诊断 中,高分辨率CT(HRCT)骨密度测量法的 使用价值。方法 选取2013年2月到2013 年3月间于我院治疗的耳硬化患者(实验 组)40例,正常对照者(对照组)42例,于 前庭窗前区置ROI行骨密度CT值的测量, 同时对耳硬化患者行气骨导差听力测量 及语频气导。将两组样本正常耳及硬化 耳骨密度平均CT值记录,将结果进行t检 验,对耳硬化患者听力水平及CT值相关 系数进行Pearson分析,CT诊断耳硬化 的功效应用ROC曲线分析。结果 对照组 前庭前区CT值在1797.72-2675.78HU之 间,平均(2168±22.64)HU,实验组前 庭前区CT值在457.82-2273.34HU之间, 平均(1368.23±75.43)HU,将两组平均 CT值进行对比,对照组明显高于实验组 (P<0.01);实验组平均CT值与气骨导差 (r=0.02,P=0.90)、与语频气导阈值 (r=0.17,P=0.16)间均无明显差异。应用 平均CT值诊断的敏感度为82.2%,鉴别耳 硬化的ROC曲线面积为0.85(P<0.05),诊 断阈值为1927.16HU,特异性为91.3%。结 论 在耳硬化症的诊断中,骨密度测量效 果明显,但于听力评估方面上并不理想。
Objective To discuss the diagnosis of otosclerosis, a high-resolution CT (HRCT) BMD measurement of use value. Methods April 2011 to March 2012 in our hospital patients with otosclerosis (experimental group) 40 cases of normal controls (control group) 42 cases, the window area is set in the vestibular bone density CT value ROI The the measure, while patients with otosclerosis air-bone gap measure hearing and speech frequency air conduction. The two samples of normal ear and ear bone sclerosis average CT value recording, the t-test results for otosclerosis patient hearing level and CT value Pearson correlation coefficient analysis, CT diagnosis of otosclerosis efficacy using ROC curve analysis. Results CT Pretrial area between the control group 1797.72-2675.78HU, average (2168±22.64) HU, the experimental group Pretrial district CT values between 457.82-2273.34HU, average (1368.23±75.43) HU, the two The mean CT values were compared, the control group was significantly higher than those in the experimental group (P<0.01); the experimental group, the average CT value of air-bone gap (r=- 0.01, P=0.93), and the speech frequency air conduction threshold (r=0.17, P=0.18) were not significantly different between. CT diagnosis using an average value of the sensitivity of 82.2%, ROC curve otosclerosis to identify an area of 0.85 (P<0.05), the diagnostic threshold 1927.16HU, specificity was 91.3%. Conclusion The diagnosis of otosclerosis, the bone density measurement effect is obvious, but on hearing assessment is not ideal.
【关键词】X线计算机;耳硬化症
【中图分类号】R445.3
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.04.004
前言
导致成人后天性耳聋的因素很多,其中耳硬化症最为常见,耳硬 化症为一种原发性疾病,通常于颞骨耳囊为高发部位,且目前研究 中,尚无法明确该病发病机制。在高分辨率CT(high resonlutionCT, HRCT)尚未出现时,临床多以传统的方法来诊断此病,如患者症状、听 力图改变、家族史等。耳硬化症的病变可于HRCT上直接显示,显示结 果可以提高耳硬化症术前评估的可靠性。由于病变受累区域的不同, 可将耳硬化症大体分为耳蜗型、前庭窗型与混合型三种,其中前庭窗 型耳硬化症的临床出现率最高。前庭窗前区密度降低为前庭窗型的 主要表现,造成该情况的原因是病灶累及镫骨底板及前庭窗周围的骨 质[1]。高分辨率CT对活动性耳硬化症及洱海棉花的低密度病灶较为敏 感,检测率较高。本文对正常耳前庭区及耳硬化症患者耳前庭窗区骨 密度进行定量分析,同时讨论耳硬化患者前庭前区密度降低和听力水 平之间联系,讨论于听力评估与耳硬化症的诊断中骨密度测量法的使 用价值,现报道如下。
中国CT和MRI杂志
第14卷, 第 4 期
2016年04月
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