The Efficacy of Color Mapped Fusion Images in the Diagnosis and Treatment of Cholesteatoma Using Transcanal Endoscopic Ear Surgery
The Efficacy of Color Mapped Fusion Images in the Diagnosis and Treatment of Cholesteatoma Using Transcanal Endoscopic Ear Surgery
复制标题
彩色映射融合图像在经耳道内窥镜耳外科手术中诊断和治疗胆脂瘤的疗效
DOI：
10.1097/mao.0000000000000675
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发表时间：
2015
影响因子：
2.1
通讯作者：
S. Kakehata
中科院分区：
文献类型：
--
作者：
Tomoo Watanabe;Tsukasa Ito;Takatoshi Furukawa;Kazunori Futai;Toshinori Kubota;M. Kanoto;Yuuki Toyoguchi;T. Hosoya;S. Kakehata
目的评价彩色图像融合技术（CMFI）在术前评估中耳乳突瘤的解剖位置及确定经鼻内镜手术适应证中的作用。研究设计前瞻性病例研究。设置一个单一的大学医院。92例拟行中耳乳突瘤手术的患者。首先使用回波平面扩散加权成像（EPI）对第一组患者进行干预成像分析，结果好坏参半。然后在第二组中使用1 mm薄层非EPI结合磁共振脑池造影进行成像分析。然后使用颜色映射处理所得图像，以创建增强胆脂瘤可视化的CMFI。对第三组也进行了第二次非EPI，结合T1加权图像（T1 WI）以减少假阳性。将EPI、非EPI/CMFI和非EPI/T1 WI增强CMFI的术前结果与术中结果进行比较。同时对各组的阳性预测值和阴性预测值进行评价。结果CMFI在中耳各部位的阳性预测值和阴性预测值均较高，CMFI可准确定位3 mm及以上的中耳乳突瘤。最后18例患者行T1 WI鉴别胆脂瘤和胆固醇肉芽肿，假阳性率进一步降低。结论CMFI结合T1 WI是评价直径≥ 3 mm的中耳乳突瘤解剖位置及确定经鼻内镜手术适应证的可靠方法。
Objective To assess the efficacy of color mapped fusion images (CMFIs) in preoperatively evaluating the anatomic location of cholesteatomas and determining whether a patient is indicated for transcanal endoscopic ear surgery. Study Design Prospective case study. Setting A single university hospital. Patients Ninety-two patients scheduled for middle ear cholesteatoma surgery. Intervention Imaging analysis was first performed using echo planar diffusion-weighted imaging (EPI) for the first patient group with mixed results. Imaging analysis was then performed using 1-mm thin-slice non-EPI combined with magnetic resonance cisternography in a second group. The resulting image was then processed using color mapping to create a CMFI that enhanced cholesteatoma visualization. A second non-EPI was also performed on the third group, incorporating a T1-weighted image (T1WI) to reduce false-positives. Main Outcome Measure(s) Preoperative findings from EPI, non-EPI/CMFIs, and non-EPI/T1WI-enhanced CMFIs were compared with intraoperative findings. The positive predictive value and negative predictive value were also evaluated for each group. Results Both the positive predictive value and negative predictive value obtained from the CMFIs were high in all areas of the middle ear, and CMFI facilitated accurate detection of the anatomic location of cholesteatomas of 3 mm or larger. The incidence of false-positives was further reduced in the final 18 patients by performing T1WI to distinguish between cholesteatomas and cholesterin granulomas. Conclusion CMFI combined with T1WI is a reliable diagnostic modality for evaluating the anatomic location of cholesteatomas 3 mm or larger and determining whether transcanal endoscopic ear surgery is indicated for treatment in such cases.
影响因子：
3.3
作者：
Bammer, R
通讯作者：
Bammer, R