颞骨HRCT三维重建测量乳突气房表面积与容积的临床意义

Surface area and volume measurement of mastoid air cells by 3D reconstruction based on HRCT

摘要:

目的 通过颞骨HRCT三维重建测量乳突气房表面积（SA）、容积（V），以揭示健康气化型乳突气房SA、V、表面积容积比（SA/V）的参考值范围及特征，为进一步乳突气房功能研究、生理建模及功能重建提供依据。方法 回顾性分析2016年1月—2017年6月广州市红十字会医院108例（216耳）乳突气化型成年患者的颞骨HRCT资料。使用Mimics 21.0三维重建颞骨HRCT乳突气房并测量其SA、V、SA/V，采用SPSS 25.0软件确定参考值范围，Mann-Whitney U检验比较上述测量值在性别间的差异，配对Wilcoxon检验比较SA、V在左右耳间的差异，配对t检验比较SA/V在左右耳间的差异。结果 108例（216耳）气化型乳突气房SA呈偏态分布，中位数为9 220.20（6 837.42~12 472.07）mm²，95%参考值范围为3 105.70～21 218.66 mm²；V呈偏态分布，中位数为7 255.86（5 178.03~9 796.77）mm³，95%参考值范围为2 185.78～19 297.57 mm³；SA/V呈正态分布，平均为（1.309 8±0.244 4）mm^-1，95%参考值范围为0.830 8～1.788 8 mm^-1；男性乳突气房SA、V均大于女性，差异具有统计学意义（P均<0.05），男性乳突气房SA/V小于女性，差异具有统计学意义（P<0.05）；左耳与右耳乳突气房SA、SA/V均无明显区别，差异无统计学意义（P>0.05），左耳乳突气房V大于右耳，差异具有统计学意义（P<0.05）。结论 健康乳突气化型成年人中，SA、V、SA/V的95%参考值范围分别为3 105.70～21 218.66 mm²、2 185.78～19 297.57 mm³、0.830 8～1.788 8 mm^-1；SA、V在个体间存在较大差异，SA/V在个体间差异较小。这些数据可为临床乳突功能重建提供参考。

Abstract:

Objective The aim of this study was to reveal the range and characteristics of surface area(SA), volume(V) and surface area volume ratio(SA/V) of mastoid air cells based on healthy pneumatic mastoid adult temporal bone HRCT(High Resolution CT), 3D reconstruct mastoid air cells by medical image control system. It provides the basis for further study of mastoid gas cells function, physiological modeling and reconstruction. Methods It was retrospectively analyzed for the temporal bone HRCT data of 108 (216 ears) adult patients with mastoid of pneumatic type in Guangzhou Red Cross Hospital from January 2016 to June 2017. All patients were excluded from middle ear disease. Mimics 21.0 medical imaging control system was used to reconstruct the temporal bone HRCT mastoid air cells, and measure its SA, V, SA/V. SPSS 25.0 software was used to determine the reference value range.The Mann-Whitney U test was used to compare the gender differences of the above measured values. The paired Wilcoxon test was used to compare the differences of SA and V between the left and right ears, and a paired t-test measures for the differences of SA/V between the left and right ears. Results In 108 cases (216 ears), the pneumatic mastoid air cells SA showed a skewed distribution with the median value of 9 220.20 (6 837.42~12 472.07) mm²; the 95% reference value range was 3 105.70~21 218.66 mm². V was skewed, with the median of 7 255.86 (5 178.03~9 796.77) mm³, and the 95% reference value range was 2 185.78~19 297.57 mm³. SA/V is normally distributed, with an average (1.309 8±0.244 4)mm^-1, and the 95% reference value range was 0.830 8~1.788 8 mm^-1. The SA and V of mastoid air cells in male were all larger than that in female, and the difference was statistically significant (P<0.05), while the SA/V in male was less than that in female, and the difference was statistically significant (P<0.05). There was no significant difference between left ear and right ear in SA and SA/V of mastoid air cells (P>0.05). The V of the left ear and the mastoid was greater than that of the right ear, and the difference was statistically significant (P<0.05). Conclusions The 95% reference values of SA, V and SA/V were 3 105.70~21 218.66 mm², 2 185.78~19 297.57 mm³ and 0.830 8~1.788 8 mm^-1 respectively in healthy adults with mastoid of pneumatic type. There were significant differences in SA and V, but small differences in SA/V among individuals. The data can provide a reference for clinical reconstruction of mastoid function.