光学相干断层扫描用于定量即时耳部成像

文献信息

中文摘要

目的： 确定光学相干断层扫描（OCT）耳镜能否提供鼓膜（TM）的定量形态学测量，从而区分异常耳与正常对照。
方法： 使用OCT耳镜对耳病患者和正常志愿者进行成像。整合视频耳镜与同步OCT成像引导探头定位。获取OCT体积图像（每次<5秒）并融合以生成鼓膜和中耳（ME）的宽视野体积图像。使用半自动分割分析数据集，以量化鼓膜厚度和表面形态。
结果： 对55名受试者（63耳；16耳正常，10耳内陷袋，17耳术后，10耳穿孔，10耳胆脂瘤）进行了成像。OCT体积成像一致地区分了正常、病理和术后的鼓膜。与对照组相比，所有病理组和术后组的平均鼓膜厚度均显著更大（p<0.05）。表面梯度映射显示正常鼓膜具有特征性模式，而在疾病状态下该模式被破坏，内陷袋显示出与扁平轮廓一致的广泛低梯度区域。纵向成像证明了追踪疾病进展的能力；在一例中，内陷袋在1年内进展至接触耳蜗岬并伴有相关局灶性增厚。
结论： OCT耳镜能够对鼓膜和中耳进行快速、无创的即时体积成像。它提供了提高诊断准确性和客观监测疾病进展的定量指标。OCT耳镜有潜力成为常规临床实践中的有价值工具。

英文摘要

OBJECTIVE: To determine whether an optical coherence tomography (OCT) otoscope can provide quantitative morphological measurements of the tympanic membrane (TM) that distinguish abnormal ears from normal controls.
METHODS: Patients with ear disease and normal volunteers were imaged using an OCT otoscope. Integrated video otoscopy with simultaneous OCT imaging guided probe positioning. OCT volumes (< 5 s each) were acquired and fused to generate wide-field volumetric images of the TM and middle ear (ME). Datasets were analyzed using semi-automated segmentation to quantify TM thickness and surface morphology.
RESULTS: Fifty-five subjects (63 ears; 16 normal, 10 retraction pockets, 17 postoperative, 10 perforations, 10 cholesteatomas) were imaged. OCT volumetric imaging consistently distinguished normal, pathologic, and postoperative TMs. Mean TM thickness was significantly greater in all pathologic and postoperative groups compared to controls (p < 0.05). Surface gradient mapping demonstrated a characteristic pattern in normal TMs that was disrupted in disease states, with retraction pockets showing broad regions of low gradient consistent with a flattened contour. Longitudinal imaging demonstrated the ability to track disease progression; in one case, a retraction pocket progressed over 1 year to contact the cochlear promontory with associated focal thickening.
CONCLUSIONS: OCT otoscopy enables rapid, noninvasive, point-of-care volumetric imaging of the TM and ME. It provides quantitative metrics that improve diagnostic accuracy and allow objective monitoring of disease progression. OCT otoscopy has the potential to become a valuable tool in routine clinical practice.