[摘要] 目的 探讨螺旋CT( spiral computed tomography,SCT)高分辨率扫描及扫描后三维重建对颞骨病变的诊断价值。方法 颞骨螺旋CT薄层扫描，层厚1.0mm，骨算法，FOV 9.6cm，间隔0.1mm密集重建。对34例正常和30例异常耳部进行三维重建和听骨链CT仿真内镜重建。结果 64例病例中高分辨率CT显示双侧均正常34例( 68耳)，异常30例( 44耳)。其中，中耳炎19例( 29耳)，胆脂瘤2例( 3耳)，肉芽肿1例( 1耳)，前庭发育畸形1例( 1耳)，锤砧关节脱位1例( 1耳)，颈静脉球高位2例( 2耳)，颈静脉球高位伴静脉球裸露1例( 1耳)，前庭导水管扩大2例( 4耳)，耳蜗导水管扩大1例( 2耳)。本组病例横轴位高分辨率CT图像和MPR图像可以清晰显示病变部位和程度，CTVE能立体显示听骨链空间形态和结构。结论 横轴位HRCT及MPR可以显示耳部全部信息。CTVE能直接显示听骨链立体影像，但不能区分内表面密度差异。CT仿真内镜对中耳、听骨链仅可以做辅助诊断。

    [关键词] 体层摄影术，螺旋计算机；仿真内镜；听骨链；三维重建

    Spiral CT with three-dimentional reconstruction for the temporal bone and its clinical application

    HAN Ben-yi,LI Hong-ru.Department of Imageology,Shanghai Shidong Hospital,Shanghai 200438,China

    [Abstract] Objective To discuss the value of spiral computed tomography (SCT) with three-dimentional(3D) reconstruction for patients with ears disorders.Methods Spiral CT scanning of temporal bones was performed with 1.0mm slice thickness,bone algorithm,9.6cm FOV,and 0.1mm reconstruction interval in 34 normal subjects and 30 (44 ears) patients with disorders of ear.The 3D reconstruction and CT virtual endoscopy (CTVE) of auditory ossicular chain were done.Results Thirty-four cases (68 ears) were normal and 30 patients (44 ears) were abnormal among 64 cases scanned with SCT.There were chronic otitis media (29 ears),cholesteatoma type of chronic otitis media (3 ears),granulomatous type of chronic otitis media (1 ear),vestibular malformations (1 ear),luxation of the incudomalleal joint (1 ear),a high positioned jugular bulb (2 ears),an incomplete bony covering of a high positioned jugular bulb (1 ear),vestibular aqueduct dilate (4 ears),cochlear aqueduct dilate (2 ears).Of the abnormal patients,all the axial and MPR images could display the focus and severity,and CTVE images were superior to the axial images in displaying the auditory ossicular chain.Conclusion Image of axial SCT and MPR can clearly show all the informations in the middle ear.CTVE technique can diplay stereoscopic image of the auditory ossicular chain.The disadvantages of virtual endoscopy are that the density difference of the surfaces can not be differentiated.Supplementary diagnosis is applied in evaluating diseases with CTVE. ......