光子计数CT用于耳硬化症镫骨底板固定的术前评估

文献信息

中文摘要

目的： 描述经手术证实的耳硬化症镫骨底板固定的光子计数CT（PCCT）影像学表现，并评估初始放射学报告中漏诊的频率。
方法： 本回顾性病例系列纳入18例经手术证实的耳硬化症患者，这些患者于2023年3月至2024年12月期间接受了颞骨PCCT检查。对PCCT图像进行回顾性审阅，以评估镫骨底板受累的影像学表现，如镫骨底板增厚或密度减低，并与术中所见进行相关性分析。审阅原始放射学报告，以确定这些表现是否在术前被识别。
结果： 在所有18例病例中，回顾性PCCT审阅均识别出镫骨底板受累的影像学表现，并与术中确认结果相关。然而，在18例患者中有8例（44%），这些表现在回顾性PCCT上可识别，但未在初始放射学解读中报告。
结论： PCCT能够极好地显示与经手术证实的耳硬化症镫骨底板固定相关的形态学改变。近半数这些表现未在初始放射学解读中被识别，凸显了提高放射科医生对细微窗性耳硬化症的认识和报告的机会。更熟悉这些影像学表现可能有助于增强术前评估并促进手术规划。

英文摘要

PURPOSE: To describe the photon-counting CT (PCCT) imaging findings of surgically confirmed stapes footplate fixation in otosclerosis and to assess the frequency of missed diagnoses on initial radiology reports.
METHODS: This retrospective case series included 18 patients with surgically confirmed otosclerosis who underwent temporal bone PCCT between March 2023 and December 2024. PCCT images were retrospectively reviewed for imaging findings of stapes footplate involvement, such as increased thickness or hypoattenuation of the stapes footplate, and correlated with intraoperative findings. Original radiology reports were reviewed to determine whether these findings were identified preoperatively.
RESULTS: Imaging findings of stapes footplate involvement were identified on retrospective PCCT review in all 18 cases, correlating with intraoperative confirmation. However, in 8 of 18 patients (44%), these findings were retrospectively identifiable on PCCT but not reported in the initial radiologic interpretation.
CONCLUSION: PCCT enables excellent visualization of morphologic changes associated with surgically confirmed stapes footplate fixation in otosclerosis. Nearly half of these findings were not recognized on the initial radiology interpretation, highlighting an opportunity to improve radiologist awareness and reporting of subtle fenestral otosclerosis. Greater familiarity with these imaging findings may enhance preoperative assessment and facilitate surgical planning.