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Objective To explore the value of HRCT and contrast-enhanced MRI in diagosis of facial nerve injuries.Methods HRCT and contrast-enhanced MRI were performed in 18 cases of facial nerve injuries.CPR of the facial nerve and canal was performed on the Philips EBW workstation,and the temporal bone involved location,fracture type and involvement of facial nerve and canal and its course were observed.The involved location,size,signal variation of facial nerve were analyzed compared with contralateral side on the GE AW 4.5 workstation.Results Among 18 cases,8 cases of longitudinal fractures,5 cases of transverse fractures and 5 cases of mixed fractures were found.HRCT axial scan and CPR of facial canal revealed that 18 cases had temporal bone fractures,including 1 case of labyrinthine segment,2 cases of geniculate fossa,4 cases of tympanic segment,2 cases of geniculate fossa,tympanic segment and hematoma of middle ear cavity,3 cases of tympanic segment with adjacent hematoma of middle ear cavity and 6 cases without obvious fracture of facial canal.Contrast-enhanced MRI and CPR of facial nerve revealed facial nerve injuries in all 18 cases,including 12 cases of internal auditory meatus segment,14 cases of labyrinthine segment,18 cases of geniculate ganglion,16 cases of tympanic segment and 15 cases of mastoid segment.Signal intensity ratio of affected internal auditory meatus segment,labyrinthine segment,geniculate ganglion,tympanic segment and mastoid segment were higher than those of contralateral side (all P＜ 0.001).Conclusion HRCT and contrast-enhanced MRI can clearly reveal the involvement of different segment of traumatic facial nerve,HRCT CPR and MR CPR are helpful to visualiz the involvement of traumatic facial nerve and canal.
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Objective To explore the application value of contrast-enhanced MRI and curved planar reformation (CPR) in diagnosis of facial neuritis.Methods Contrast-enhanced MRI scans were performed on 30 patients with facial neuritis.The involvement of intracranial facial nerve was observed,and the signal intensity of facial nerve and adjacent temporal lobe was measured with GE AW 4.5 workstation.While the signal intensity ratio (SIR) between facial nerve and adjacent temporal lobe was calculated.CPR of facial nerve was done with Philips EBW workstation,in order to observe the whole course and involvement of facial nerve.Results Among the 30 patients,SIR of affected geniculate ganglion,tympanic segment,labyrinthine segment,internal auditory meatus segment and mastoid segment was 1.59±0.28,1.16±0.16,1.38±0.20,1.30 ±0.19 and 0.96±0.14,respectively.While SIR of the relevant segment in contralateral side was 1.08±±0.19,0.74±0.13,0.81±0.13,0.83±0.08 and 0.69±0.12,respectively.There were significant differences of SIR between the affected and the contralateral segments (all P＜0.001).CPR could display the involved location and facilitate visualizing the whole course of facial nerve clearly.Conclusion Contrast-enhanced MRI and CPR are helpful to facilitate visualizing the whole course of facial nerve and clearly reveal the involvement.
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Objective To explore the value of HRCT for the diagnosis of internal ear injuries caused by temporal bone trauma.Methods Totally 106 patients with temporal bone trauma were scanned by HRCT,and 12 patients with internal ear injuries were collected.MPR of temporal bone (cochlea,vestibule,horizontal semicircular canal,anterior semicircular canal and posterior semicircular canal) was performed on Philips workstation.The locations,types,and the involving structures were observed.Results Among the 106 cases of temporal bone trauma,12 cases were internal ear injuries,including 8 cases of fractures of inner ear,3 cases of pneumolabyrinth,and 1 case of foreign body in the cochlea,which 3 cases complicated with traumatic labyrinthine ossification.Conclusion HRCT and MPR can clearly reveal internal ear injuries,which are effective methods for diagnosis of internal ear injuries.
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Objective To explore the application value of 256-slice high resolution CT(HRCT)and reconstuction technique in the preoperative assessment of ossicular chain trauma.Methods 106 cases of temporal bone trauma were scanned using 256-slice HRCT,38 cases of ossicular chain trauma were collected.The multi-planar reformaition(MPR),curved plannar reformation(CPR) and three-dimensional volume rendering reformation (3D VR)of the ossicular chain were performed on Philips work station.The locations, types and the involving structures were analyzed,then these cases were followed up.The display rates of AX,MPR,CPR,3D VR were evaluated.Results Among 106 cases of temporal bone trauma,38 cases(76 ears)were found ossicular chain trauma,in which there were 43 ears of ossicular dislocation,22 ears incudomalleolar joint separation,6 ears incudomalleolar and incudostapedial joint separation,3 ears incudostapedial joint separation,11 ears translocation of the ossicles,1 ear stapediovestibular dislocation;4 ears ossicular fractures,2 ears fracture of the malleus,1 ear fracture of the incus,1 ear fracture of the stapes.Among 38 cases,11 cases underwent surgery,and the surgical results were consistent with CT findings.The display rates of AX,MPR,CPR,3D VR were 97.87％,100％, 97.87％,82.98％ respectively.Conclusion 256-slice HRCT and reconstuction technique can clearly reveal the whole structure of ossicular chain trauma,which are effective methods for diagonsis of ossicular chain trauma before surgery.
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Objective To explore the value of HRCT for the diagnosis of internal ear injuries caused by temporal bone trauma.Methods Totally 106 patients with temporal bone trauma were scanned by HRCT,and 12 patients with internal ear injuries were collected.MPR of temporal bone (cochlea,vestibule,horizontal semicircular canal,anterior semicircular canal and posterior semicircular canal) was performed on Philips workstation.The locations,types,and the involving structures were observed.Results Among the 106 cases of temporal bone trauma,12 cases were internal ear injuries,including 8 cases of fractures of inner ear,3 cases of pneumolabyrinth,and 1 case of foreign body in the cochlea,which 3 cases complicated with traumatic labyrinthine ossification.Conclusion HRCT and MPR can clearly reveal internal ear injuries,which are effective methods for diagnosis of internal ear injuries.
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Objective To explore the application value of 256-slice high resolution CT(HRCT)and reconstuction technique in the preoperative assessment of ossicular chain trauma.Methods 106 cases of temporal bone trauma were scanned using 256-slice HRCT,38 cases of ossicular chain trauma were collected.The multi-planar reformaition(MPR),curved plannar reformation(CPR) and three-dimensional volume rendering reformation (3D VR)of the ossicular chain were performed on Philips work station.The locations, types and the involving structures were analyzed,then these cases were followed up.The display rates of AX,MPR,CPR,3D VR were evaluated.Results Among 106 cases of temporal bone trauma,38 cases(76 ears)were found ossicular chain trauma,in which there were 43 ears of ossicular dislocation,22 ears incudomalleolar joint separation,6 ears incudomalleolar and incudostapedial joint separation,3 ears incudostapedial joint separation,11 ears translocation of the ossicles,1 ear stapediovestibular dislocation;4 ears ossicular fractures,2 ears fracture of the malleus,1 ear fracture of the incus,1 ear fracture of the stapes.Among 38 cases,11 cases underwent surgery,and the surgical results were consistent with CT findings.The display rates of AX,MPR,CPR,3D VR were 97.87％,100％, 97.87％,82.98％ respectively.Conclusion 256-slice HRCT and reconstuction technique can clearly reveal the whole structure of ossicular chain trauma,which are effective methods for diagonsis of ossicular chain trauma before surgery.
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Objective To discuss the diagnostic value of high resolution computed tomography (HRCT)and MRI in the congenital inner ear malformation incomplete partition type Ⅱ deformity(Mondini deformity)combined with spontaneous cerebrospinal fluid (CSF)otorrhea.Methods The imaging data including the multiplanar reformation(MPR)images of HRCT,curved planar reforma-tion(CPR)images and MR hydrography images in three patients complicated with recurrent meningitis were retrospectively ana-lyzed.The anatomic changes of the inner ear and middle ear on the affected side were observed,the clinical and imaging features of this disease were summarized.Results One patient had bilateral incidence of the incompletely separated inner ear,combined with semicircular canal dysplasia and cochlear pipe dilation.Two patients had unilateral onset,one of them had concurrent facial nerve ca-nal dysplasia.Humble stapes floor and the defect of the bottom of the internal auditory canal were seen in all the three patients.Con-clusion HRCT with post-processing technology,and MRI have great significance in the diagnosis of the congenital inner ear malfor-mation incomplete partition type Ⅱ deformity (Mondini deformity)combined with spontaneous CSF otorrhea.
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Objective To study MR imaging features of transient bone marrow edema syndrome of the hip so as to improve its diagnosis and differential diagnosis.Methods MR images of transient bone marrow edema syndrome of the hip in 13 patients were retrospectively analyzed in combination with literature review.Results The bilateral hips were affected in 4 patients.The single hip was affected in 9 patients,left hip in 6 and right hip in 3.The MR images demonstrated low signal intensity in all 13 patients on T1WI,and normal signal intensity in 2 patients,moderate or high signal intensity in 11 patients on T2WI,and high signal on T2 fat suppressed or STIR images in all 13 patients.The bone marrow edema pattern involved the femoral head and neck in 13 hips,the femoral head and neck and the intertrochanteric region in 4 hips.A small joint effusion was observed in 8 hips on T2WI.The configuration of femoral heads were normal.Conclusion Correct judgement of MRI manifestations of transient bone marrow edema syndrome of the hip can improve its diagnosis and differential diagnosis.
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Objective To study the curved planar reformation (CPR) imagings of bony canals in craniofacial region with multislice spiral CT.Methods CPR of the bony canals in craniofacial regions were performed in 267 cases by using Philips Mx8000 multislice spiral CT,including facial nerve canal (FNC) in 217 cases,optic nerve canal (ONC) in 28 cases,mandibular canal in 9 cases,carotid canal in 7 cases, jugular foramen in 4 cases and hypoglossal canal in 2 . Scanning parameters were as followed : 120 kV , 200~250 mAs , collimation 0.5mm, pitch 0.625 or 0.875,scan time 0.75s/ring, matrix 512?512.Collimation and reformation interval were 0.5~1.0 mm and 0.2~0.5 mm separately, except for FNC,in which were 0.5 mm and 0.2 mm separately.Reformation matrix was all 1024?1024.Results Of all cases , the images of CPR in 11 were unsatisfied because of the head shaking during the scanning, in other 256 cases , images could show the whole length of canals clearly. In FNC,178 cases were normal , 18 cases had congenital abnormal in the external , middle or inner ear accompanied with changes of length , course and position. 8 cases of otomastoiditis accompanied with cholesteatoma involving facial canal. In 21 cases of temporal bone trauma accompanied with traumatic facial palsy, fracture lines or bony fragments of the FNC were found in 9 cases. 2 cases of facial nerve tumor and 2 cases of jugular foramen schwannoma accompanied with facial canal destruction.24 cases of ONCs were normal. Fracture lines or bony fragments of ONCs were found in 3 cases. Narrowing of ONC was found in 1 cases of fibrous dysplasia.Normal carotid canal was seen in 2 cases, there were 2 cases of carotid canal fracture.1 cases of bony destruction of carotid canal caused by cholesteatoma of petrous apex. Jugular foramen was normal in 2 cases. Destruction and enlargement of jugular foramen were found in 2 cases of schwannoma. In 1 cases, hypoglossal nerve canal was normal. Destruction and enlargement of hypoglossal nerve canal were found in the other cases of schwannoma. Mandibular canal were normal in 4 cases and was involved in 2 cases by mandibular osteomyelitis and mandibular fracture,respectively, and 1 case by mandibular tumor. Conclusion The bony canals in craniofacial regions can be shown clearly by CPR with multislice spiral CT . It can provide more valuable informations than that of the axial scan and multiplanar reformation in the diagnosis of diseases of craniofacial region and was the important supplement of routine CT scan.
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Objective To evaluate MR diagnostic value of neurovascular compression in patients with hemifacial spasm(HFS). Methods MRI and MRA manifestations and operative results of eighteen patients with HFS were reviewed retrospectively.Results (1)The roots of the facial nerve involved sides were compressed by vessel in all cases.(2)There was statistical correlation between the vascular compression of the root exit zone(REZ)of facial nerves and the symptoms of HFS(P
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Objective Using curved planar reformation(CPR)to delineate the ossicular chain(OC)in one image and evaluate its clinical application. Methods HRCT of temporal bone was performed in 122 cases(165 ears).The CPR of OC was then performed.The main parameters were as follow:collimation 0.5mm,pitch 0.875,reformation interval 0.2～0.3mm,reformation matrix 1024?1024.Results (1)CPR of normal OC were performed on 80 ears,the three ossicles and its joints could be showed on one image clearly.(2)Clincal application(72cases):in 39 cases of temporal bone trauma,OCs were normal in 21 cases and abnormal in 18 cases.Subluxation or dislocation of malleoincudal joint(MIJ)(5,5) and incudostapedial joint(ISJ)(5,6),dislocation of MIJ and ISJ with rotation of incus(1 case),fracture of manubrium of malleus(1 case) were found respectively.In 16 cases of external auditory canal dysplasia(EACD),the most commonly associated type of OC deformity was absence of manubrium of malleus(10 cases)。Absence of OC associated with coarctation of middle ear cavity(3 cases) and fusion of the malleus and incus associated with absence of long process of incus represented in 1 case.Congenital ossicular anomalies without associated EACD were found in 2 cases.The long processes of the incus of both side were absent in 1 case.Incudostapedial disconnection was demonstrated in 1 case due to improper development of the long process of the incus.In 15 cases of chronic otitis media(COM),6 cases were complicated cholesteatoma.Destruction of OC was demonstrated in 6 cases.Conclusion CPR of OC with multislice spiral CT is an effective method in the diagnosis of conductive hearing loss.
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Objective To study the facial nerve canal (FNC) abnormalities of the congenital external auditory canal (EAC) atresia by MSCT curved planar reformation (CPR).Methods 15 cases(17 ears) of congenital EAC atresia were scanned by MSCT. Post-processing images were completed by Philips Mx8000 workstation.Results In 17 ears, there were 2 ears with stenosis of EAC, 2 ears with membranous atresia of EAC and 13 ears with bony atresia of EAC.There were 1 ear with congenital cholesteatoma, 3 ears with malformation of tympanum, 7 ears with malformation of the ossicular chain and 1ear with malformation of inner ear. In 17 ears with abnormalities of FNC, included 11 ears with the shortness of FNC general length, 5 ears with the anomalous course of FNC, 9 ears with the displacement of FNC, 1 ear with the narrowing of FNC and 1 ear with the branch of FNC.Conclusion MSCT CPR of FNC, combined with HRCT axial scan, can clearly show the FNC abnormalities of the congenital EAC atresia and provide valuable information for surgery.
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Objective To study the method and diagnostic value of curved planar reformation(CPR)of body canals with multislice spiral CT.Methods 50 patients with various disease of chest and abdomen scanned by multislice spiral CT.CPR of canals of chest and abdomen were performed.Results The images of CPR were acquired satisfactory in all cases.3 cases were normal.There were vascular diseases of chest in 6 cases,lung cancer in 9 cases,disease of abdominal vessels in 10 cases,disease of biliary tract in 10 cases.Carcinoma of the head of pancrease in 4 cases,ureter cancer in 4 cases,ureter stone in 2 cases,tuberculosis of ureter in 1 case,malformation of ureter in 1 case.Conclusion CPR of body canal with multislice spiral CT is an effective method in the diagnosis of various diseases of chest and abdomen.It is an useful supplement of routine CT scan.
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Objective To study the etiology and clinics as well as CT diagnostic value of periventricular leukomalacia(PVL)in children.Methods Clinical and CT findings in 130 cases of PVL were retrospectively analyzed.Results 85 cases were premature newborn babies(65.4%) and 45 cases were fullmature newborn(34.6%) with hypoxic ischemic encephalopathy.CT showed the lateralventricle enlarge in different degrees and the white matter of periventricle decreased.Conclusion CT scan is of important value indiagnosis of PVL.
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Objective To observe and measure the facial nerve canal(FNC) in curved planar reformation by multislice spiral CT.Methods High resolution computed tomography (HRCT)of temporal bone was performed in 40 cases (80 ears) by multislice spiral CT. Curved planar reformation of FNC was performed separately in axial, coronal and sagittal plane of multiplanar reconstruction. The morphology and measurement of FNC were studied.Results The mean length of FNC was (29.73?1.07)mm. The mean length of the labyrinthine, tympanic and mastoid segment was (5.6?0.74)mm, (10.66?0.79)mm and (13.47?1.01)mm respectively. The mean diameter of the l-abyrinthine, geniculate fossa, tympanic and mastoid segment was (0.76?0.16)mm, (2.37?0.63)mm, (1.03?0.16)mm and (1.57?0.31)mm respectively. The mean angle of first and second genu was 67.04??9.41? and 114.25??8.44? respectively. The distance between the tympanic segment and ampulla of the lateral semicircular canal was (0.57?0.19)mm. The distance between the tympanic segment and arch of the lateral semicircular canal was (1.59?0.61)mm. The mean angle between the tympanic segment of the facial nerve canal and the lateral semicircular canal was 10.63??3.60?. The tympanic course of the facial nerve canal formed an angle of 34.65??5.39? with the sagittal plane. Dehiscences was found in 89% FNC, 73.7% of them only located in the tympanic portion and 26.3% both in the mastoid and tympanic portions. Conclusion Curved planar reformation of FNC by multislice spiral CT is the good method to study the anatomy of FNC,and in combination with HRCT axial scan and multiplanar reconstrution can obtain more valuable information.
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Objective Adverse reactions to Gd-DTPA contrast media should be noticed enough.Methods Three cases of adverse reactions to Gd-DTPA contrast media were studied, and literatures were reviewed.Results The rate of adverse reactions to Gd-DTPA contrast media in our hospital was 0.206%.Conclusion Although the rate of adverse reactions to Gd-DTPA contrast media is very low, this problem must be noticed enough with the medical quality’s developement.
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Objective To evaluate the development of the sphenooccipital synchondrosis on high resolution CT scans.Methods 269 cases,HRCT findings of the sphenoocipital synchondrosis ranged in age from 3 months to 74 years old were analysed.Four points were assessed on HRCT scans (a) The pattern of the synchondrosis, (b) The location and time of appearance of the ossification center in the synchondrosis, (c) The vestige of the synchondrosis after fusion of the sphenoid and occipital bones and (d) The development of sphenoid sinus.Results The pattern of the sphenooccipital synchondrosis could be classified into three types, including complete opening, partial and complete closure. The spheno-occipital synchondrosis was variable in shapes in opening group,a notch existed in 57 cases, the mean of the thickness of the spheno-occipital synchondrosis was 1.8 mm, there was negative correlation between the thickness of the synchondrosis and the age (r= -0.92,P
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Objective To measure the dimension and area of the brainstem on MR images in healthy adults and to study the relationship between age, sex and the size of the brainstem.Methods The dimensions and areas of the brainstem in 360 healthy volunteers on midsagittal MR images were measured. There were 180 males and 180 females, ranged in age from 20～87 years old. Results The average antero-posterior(AP) distances and areas of the midbrain were the largest at the 20～29 years old, and decreased slightly over 60 years. The average AP distance, vertical distance and area of the frontal pontine and pontine were no significant difference between different age groups, but there were significant difference in sex. The average upper diameter and area of the medulla oblongata were significant difference in partial age groups, and there was difference in sex (?
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Objective To analyze the CT appearances and the classification of gray matter heterotopia.Methods The clinical and CT data of 26 cases with gray matter heterotopia were retrospectively reviewed,11 were males and 15 were females,ranged in age from 2 days to 9 years with a mean of 2.6 years.Results The classification of heterotopia included:(1)Subependymal heterotopia in 14,5 cases with encephaloceles,1 case with Dandy-Walker malformation and 1 case with arachnoid cyst of cisterna megna.(2)Subcortical heterotopia in 7,4 cases with callosal agenesis were accompanied.(3)Band heterotopia in 5.Conclusion CT scan can not only reveal the appearances of the subependymal,subcortical and band types heterotopia,but also show other associated abnormalities.
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0.05).The values and ages were positive correlation before age 25(r=0.71～0.91,?0.05).Four main patterns of marrow distribution were identified in the proximal femur.Our data implied that there was progressive marrow fat distribution with age.The diaphyseal red marrow began to convert to yellow marrow after 5 years old and the conversion completed at age of 10.Foci of longer T 1 signals were found in the diaphysis in some of the subjects and the percentage increased with age.The femoral head and the greater trochanter showed yellow marrow signals after ossification.Conclusion Measurement of MRI signal intensity values could be used in evaluating the conversion of red to yellow marrow of the femur.Red and yellow marrow of femur may be distinguished by MRI.We should notice the different MRI feafure in different ages.