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目的探讨多向调整多平面重组(MPR)技术全程显示听小骨及其关节的方位和方法。方法对50侧正常中耳行高分辨率CT各向同性扫描后再行多向调整MPR后处理,确定听小骨同层全程显示的基础显示方位、重组基线旋转中心点和旋转方向的定向解剖标志,测量重组基线旋转角度,对听小骨在轴面、冠状面、矢状面及多向调整MPR全程显示位4种方位上的全程显示程度进行分级,做Ridit分析和X2检验。结果多向调整MPR锤骨、砧骨、镫骨的同层全程显示率均为100％(50侧中耳),多向调整MPR对于听小骨全程显示率明显高于轴面(镫骨6侧、锤骨0侧、砧骨0侧)、冠状面(锤骨3侧、镫骨0侧、砧骨0侧)、矢状面(锤骨0侧、砧骨0侧、镫骨0侧),差异有统计学意义(P<0．01)。结论(1)各向同性扫描基础上的多向调整MPR技术提供了具有诊断意义的听小骨全程显示方法,具有重要临床应用价值。(2)只需1次扫描多次MPR后处理,就可取代多次多方位扫描,是听小骨多方位整体观察的必要途径之一。
Objective To investigate the orientation and method of multi directional multiplanar reorganization (MPR) to display ossicles and their joints. Methods Fifty normal middle-ear high-resolution computed tomography (CT) images were obtained after isotropic scanning and multi-directional MPR postprocessing to determine the orientation of the basal display, the center of rotation and the directional anatomic landmarks The rotation angles of the reconstructed baselines were measured to classify the degree of full display of the ossicles in the axial, coronal, sagittal and multi-directional adjustment of the MPR display position. Ridit analysis and X2 test were performed. Results Multi-directional adjustment of MPR malleus, incus and stapes showed 100% (50 sides) of the same layer in the same layer. The multi-directional adjustment of MPR was significantly higher than that of the axial , 0 on the malleus, 0 on the anvil), coronal (3 on the malleus, 0 on the stapes, 0 on the incus), sagittal (0 on the malleus, 0 on the incus, 0 on the stapes) , The difference was statistically significant (P <0.01). Conclusions (1) The multi-directional adjustment MPR technique based on isotropic scanning provides a diagnostic method for the whole display of ossicles, which has important clinical value. (2) It can replace multiple multi-azimuthal scanning with just one scan of multiple MPR post-treatment, which is one of the necessary ways to observe the multi-directional overall observation of the small bones.