Verification of computed tomographic estimates of cochlear implant array position: a micro-CT and histologic analysis.
Verification of computed tomographic estimates of cochlear implant array position: a micro-CT and histologic analysis.
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DOI：
10.1097/mao.0b013e3182255915
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发表时间：
2011-08
期刊：
影响因子：
--
通讯作者：
Chole RA
中科院分区：
文献类型：
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作者：
Teymouri J;Hullar TE;Holden TA;Chole RA
确定临床计算机断层扫描（CT）成像验证人工耳蜗植入（CI）患者术后电极阵列放置的有效性。对9例新鲜尸头进行临床CT扫描，然后进行双侧人工耳蜗植入和术后临床CT扫描。取出颞骨，修剪，并使用microCT扫描。然后将样本脱水，包埋在甲基丙烯酸甲酯或LR白色树脂中，并用金刚石切片锯切片。由三名不知情的观察者检查组织切片，以确定单个电极相对于耳蜗内软组织结构的位置。电极被判断为在鼓阶、前庭阶内或在阶之间的中间位置。使用microCT和组织学作为金标准，可以从所有标本的临床CT扫描中准确估计阵列的位置。利用microCT进行验证，获得了97%的一致性，组织学分析显示与临床CT结果的一致性为95%。使用临床扫描仪从患者的术前和术后CT图像导出的合成三维图像准确地估计了由微CT成像和组织学分析确定的电极阵列的位置。使用CT方法获得的信息提供了对患者性能的许多感兴趣变量的有价值的见解，例如手术技术、阵列设计和处理器编程和故障排除。
To determine the efficacy of clinical computed tomography (CT) imaging to verify post-operative electrode array placement in cochlear implant (CI) patients. Nine fresh cadaver heads underwent clinical CT scanning, followed by bilateral cochlear implant insertion and post-operative clinical CT scanning. Temporal bones were removed, trimmed, and scanned using microCT. Specimens were then dehydrated, embedded in either methyl methacrylate or LR White resin, and sectioned with a diamond wafering saw. Histology sections were examined by three blinded observers to determine the position of individual electrodes relative to soft tissue structures within the cochlea. Electrodes were judged to be within the scala tympani, scala vestibuli, or in an intermediate position between scalae. The position of the array could be estimated accurately from clinical CT scans in all specimens using microCT and histology as a gold standard. Verification utilizing microCT yielded 97% agreement, and histological analysis revealed 95% agreement with clinical CT results. A composite, three-dimensional image derived from a patient’s pre- and post-operative CT images using a clinical scanner accurately estimates the position of the electrode array as determined by microCT imaging and histological analyses. Information obtained using the CT method provides valuable insight into numerous variables of interest to patient performance such as surgical technique, array design, and processor programming and trouble-shooting.