自动耳蜗形态测量：头部CT与颈动脉CT血管造影、颈椎及鼻窦CT的个体内比较
Automatic cochlear morphometry: intraindividual comparison of head CT vs carotid CT angiography, cervical spine, and paranasal sinus CT.
文献信息
| PMID | 42742655 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Henner Huflage |
| 作者单位 | Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany. Huflage_H@ukw.de. |
| 期刊 | European radiology |
| SCI 分区 | Q1 |
| IF | 5.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 在人工耳蜗植入中，精确估计耳蜗管长度（CDL）对于个体化电极阵列选择至关重要。本研究对基于头部CT与颈椎、颈动脉及鼻窦成像的CDL测量进行了个体内比较。
材料与方法： 在这项回顾性研究中，对459例患者（年龄70.7±17.8岁，女性240例）进行了针对Corti器的自动CDL测量，这些患者均接受了头部CT（120 kVp）以及颈椎CT（Sn 150 kVp，293例）、颈动脉CT血管造影（100 kVp，133例）或鼻窦CT（Sn 100 kVp，33例）检查。此外，还比较了辐射剂量和对比噪声比。
结果： 头部CT（中位数53.2 [四分位距49.6-56.8] mGy）的CTDIvol高于颈椎（16.3 [15.6-16.9] mGy）、颈动脉（8.4 [8.2-8.7] mGy）和鼻窦CT（固定5.0 mGy；p < 0.001）。头部CT的CNR（24.3 [21.4-27.1]）高于颈动脉（17.9 [15.3-20.6]）、颈椎（12.3 [10.9-13.6]）和鼻窦CT（6.6 [5.7-7.4]；p < 0.001）。头部CT（35.5 [34.4-36.5] mm）与颈椎（35.5 [34.3-36.5] mm；p = 0.371）和鼻窦CT（35.0 [34.3-36.1] mm；p = 0.112）之间未发现个体内CDL差异，而在颈动脉样本中发现了微小但具有统计学意义的差异（35.4 [34.4-36.4] mm；p < 0.001）。
结论： 尽管CNR较低，基于颈椎、颈动脉和鼻窦CT的CDL测量结果与头部CT成像相当，表明在耳蜗形态测量中具有显著降低剂量的潜力。
要点： 问题：覆盖颞骨的技术上不同的低剂量方案能否在大型真实世界患者样本中提供稳健的自动CDL测量？发现：在459例患者中，尽管CNR较低，来自颈动脉血管造影、颈椎和鼻窦CT的自动耳蜗形态测量在个体内与头部CT相当。临床相关性：验证来自覆盖颞骨的各种常规CT方案的自动CDL测量，使得能够以大幅降低的辐射暴露进行机会性人工耳蜗植入规划。
英文摘要
PURPOSE: In cochlear implantation, precise estimation of cochlear duct length (CDL) is essential for individualized electrode array selection. This study provides an intraindividual comparison of CDL measurements based on head CT vs cervical spine, carotid artery, and paranasal sinus imaging.
MATERIALS AND METHODS: For this retrospective investigation, automatic CDL measurements focused on the organ of Corti were performed in 459 patients (70.7 ± 17.8 years, 240 women), who underwent both head CT (120 kVp) and either cervical spine CT (Sn 150 kVp, 293 patients), carotid CT angiography (100 kVp, 133 patients), or paranasal sinus CT (Sn 100 kVp, 33 patients). Additionally, radiation dose and contrast-to-noise ratios were compared.
RESULTS: Head CT (median 53.2 [interquartile range 49.6-56.8] mGy) was associated with a higher CTDIvol than cervical spine (16.3 [15.6-16.9] mGy), carotid artery (8.4 [8.2-8.7] mGy), and paranasal sinus CT (fixed 5.0 mGy; p < 0.001). CNR was higher in head CT (24.3 [21.4-27.1]) compared with carotid artery (17.9 [15.3-20.6]), cervical spine (12.3 [10.9-13.6]), and paranasal sinus CT (6.6 [5.7-7.4]; p < 0.001). No intraindividual CDL difference was ascertained for head CT (35.5 [34.4-36.5] mm) vs cervical spine (35.5 [34.3-36.5] mm; p = 0.371) and paranasal sinus CT (35.0 [34.3-36.1] mm; p = 0.112), whereas a small, but statistically significant difference, was found in the carotid artery sample (35.4 [34.4-36.4] mm; p < 0.001).
CONCLUSION: Despite lower CNR, CDL measurements based on cervical spine, carotid artery, and paranasal sinus CT yield comparable results to head CT imaging, suggesting potential for considerable dose reduction in cochlear morphometry.
KEY POINTS: Question Do technically diverse low-dose protocols covering the temporal bone provide robust automatic CDL measurements in a large real-world patient sample? Findings In 459 patients, automatic cochlear morphometry from carotid angiography, cervical spine, and paranasal sinus CT was intraindividually comparable to head CT, despite lower CNR. Clinical relevance Validation of automatic CDL measurements from various routine CT protocols covering the temporal bone enables opportunistic cochlear implant planning with substantially reduced radiation exposure.