摘要
目的:探讨高分辨率CT(HRCT)扫描中前庭窗前区与锤骨头密度差值在诊断前庭窗型耳硬化症中的应用价值。方法:回顾性分析经临床确诊的107例前庭窗型耳硬化症患者(耳硬化组)和112例中耳炎患者(慢性中耳炎组)以及110例正常对照者(对照组),将感兴趣区(ROI)分别置于前庭窗前区和锤骨头区域进行骨密度CT值测量并计算出三组前庭窗前区与同侧锤骨头的CT值差值。采用受试者工作特征(ROC)曲线评价应用CT平均值和差值诊断耳硬化症的效能。结果:耳硬化组前庭窗前区平均CT值(1112.64 HU)明显低于慢性中耳炎组和对照组(2071.63 HU;2086.20 HU)(c=-15.821,P<0.001;c=-16.371,P<0.001);前庭窗前区与锤骨头密度差值平均值(-610.63 HU)明显低于慢性中耳炎组和对照组(237.46 HU;244.35 HU)(c=-15.232,P<0.001;c=-15.762,P<0.001);3组锤骨头平均CT值(1811.99 HU;1830.62 HU;1832.61 HU)无明显的统计学差异(P=0.076)。采用前庭窗前区平均CT值鉴别耳硬化症与慢性中耳炎的ROC曲线下面积(AUC)为0.964(P<0.001),诊断阈值为1892.42 HU,诊断的敏感度90.63%,特异度93.92%;采用前庭窗前区平均CT值鉴别耳硬化症与正常耳的AUC为0.967(P<0.001),诊断阈值为1892.42 HU,诊断的敏感度92.27%,特异度93.92%。CT差值<0作为诊断耳硬化症的标准,诊断的灵敏度87.85%,特异度98.20%,AUC为0.930(P<0.001)。结论:骨密度差值在前庭窗型耳硬化症的诊断中具有更加显著的灵敏度以及客观性。差值≤0即当前庭窗前区低于同侧锤骨头骨密度值时应考虑前庭窗型耳硬化症的诊断可能。
Objective:To investigate the value of the density difference between the vestibular window area and the malleus head in the diagnosis of fenestral otosclerosis with high resolution CT(HRCT)scanning.Methods:A retrospective analysis of 107 clinically confirmed patients with fenestral otosclerosis(otosclerosis group),112 otitis media patients(chronic otitis media group)and 110 normal controls(control group)in our hospital was conducted.The area of interest(ROI)was placed in the vestibular window area and the malleus head area respectively to measure the bone density CT value,and the difference value between the vestibular window area and the ipsilateral malleus head were calculated in the three groups.Receiver operating characteristic(ROC)curve was used to evaluate the efficacy of CT mean and difference in the diagnosis of otosclerosis.Results:The mean CT value of the vestibular window area in otosclerosis group(1112.64HU)was significantly lower than that in chronic otitis media group and control group(2071.63HU;2086.20HU)(c=-15.821,P<0.001;c=16.371,P<0.001);The average of the difference(-610.63HU)was significantly lower than that of chronic otitis media group and control group(237.46HU;244.35HU)(c=-15.232,P<0.001;c=15.762,P<0.001).Average CT value of malleus head in three groups(1811.99HU;1830.62HU;1832.61HU)had no significant statistical difference(P=0.076).The area under the ROC curve(AUC)for distinguishing otosclerosis from chronic otitis media by mean CT value in vestibular window area was 0.964(P<0.001),the diagnostic threshold was 1892.42HU,the diagnostic sensitivity was 92.27%,the specificity was 93.92%;The AUC for distinguishing otosclerosis from normal ear by mean CT value in vestibular window area was 0.967(P<0.001),the diagnostic threshold was 1892.42HU,the sensitivity and specificity were 90.63%and 93.92%,respectively.CT difference less than 0 was used as the standard for the diagnosis of otosclerosis,with a sensitivity of 87.85%,specificity of 98.20%and AUC of 0.930(P<0.001).Conclusion:Bone mineral den
作者
伊景如
陈雪霞
白奥涵
潘初
YI Jing-ru;CHEN Xue-xia;BAI Ao-han(Department of Radiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)
出处
《放射学实践》
CSCD
北大核心
2022年第10期1226-1231,共6页
Radiologic Practice
