Objective To discuss the value of enlargement of geniculate fossa of facial nerve canal in the diagnosis of facial nerve canal fracture.Methods Thirty patients with facial nerve canal fracture underwent axial and coronal CT scan.The correlation between the fracture and the enlargement of geniculate fossa of facial nerve canal was analyzed.The ability of showing the fracture and enlargement of geniculate fossa of facial nerve canal in axial and coronal imaging were compared.Results Fracture of geniculate fossa of facial nerve canal was found in the operation in 30 patients,while the fracture was detected in CT in 18 patients.Enlargement of geniculate ganglion of facial nerve was detected in 30 patients in the operation,while the enlargement of fossa was found in CT in 28 cases.Enlargement and fracture of geniculate fossa of facial nerve canal were both detected in CT images in 18 patients.Only the enlargement of geniculate fossa of facial nerve canal was shown in 12 patients in CT.Conclusion Enlargement of geniculate fossa of facial nerve canal was a useful finding in the diagnosis of fracture of geniculate fossa in patients with facial paralysis,even no fracture line was shown on CT images.

Objective To evaluate the diagnostic value of oblique axial multiplanar reformation(MPR)imaging in detecting the fracture of geniculate fossa of facial nerve canal and its nearby.Methods 33 cases of facial nerve canal or nearby fracture confirmed by surgery were collected.CT findings(including conventional axial,coronal and oblique axial MPR images)were retrospectively analysed in comparison with that of operation.The diagnostic corresponding rate of two diagnostic modes(the combination of routine axial and coronal imagings,the combination of routine axial,coronal and oblique axial imagings)were compared.Results The fractures of geniculate fossa or the proximate of tympanic segment were seen in 22 cases on pre-operation CT images,including 8 cases on routine axial images,6 cases on routine coronal images and 20 cases on oblique axial MPR images.Local enlargement of geniculate fossa or the proximate of tympanic segment were seen in 26 cases on oblique axial MPR images.There were significant differences between these two diagnostic modes.Conclusion Oblique axial MPR images in combined with routine axial and coronal images can improve the diagnostic corresponding rate of the fracture of geniculate fossa and its nearby.

Objective To study the positions and ways of displaying the panorama of the ossicles in one plane respectively by multi-direction adjusting multi-planar reformation (MPR). Methods Fifty normal middle ears were scanned by using the HRCT isotropic parameters, and multi-direction adjusting MPR was performed to find out the basic positions, the rotating central point of reformation basic line, and the anatomic structure orientated the adjusting directions. The angles between adjusting lines and reformation baselines were measured. The axial, coronal, sagittal and multi-adjusting MPR images were graded according to the display of the ossicles. Then Ridit analyses and X2 test were performed. Results The demonstrating ratios of the panoramas of the malleus, incus, and stapes in one plane in multi-adjusting MPR images were 100% (50 middle ear) . The ratios were higher than those of axial (6 stapes, 0 malleus, 0 incus) , coronal (3 malleus, 0 incus, 0 stapes) , and sagittal images (0 malleus, 0 incus, 0 stapes) (Ridit analysis, P

0.05] .MPR images of patients with scan parameter of pitch 0.875, collimation 0.5 mm, and increment 0.3m could also reach the isotropy (0.02

Objective To analyze retrospectively the HRCT signs in the patients with invasive pulmonary aspergillosis and evaluate the value of HRCT in the diagnosis of invasive pulmonary aspergillosis.Methods The cilinical and HRCT images of 30 cases with invasive pulmonary aspergillosis diagnosed by fiber bronchoscopy, CT guided biopsy or sputum culture were collected.HRCT images were analyzed and the HRCT signs were summarized by two experienced chest imaging radiologists.Results 19 patients had a variety of CT signs, the sign of tree in bud was seen in 8 cases, bronchial stenosis 6 cases, bronchiectasis 8 cases, ground-glass opacity 8 cases, acinic nodules 10 cases, nodular lesions 12 cases, acinar nodules with halo sign 4 cases, nodules with halo sign 9 cases, cavity 10 cases.11 cases only had a single CT sign, the sign of tree in bud was seen in 2 cases, bronchiectasis 2 cases, ground-glass opacity 1 case, acinar nodules 2 cases, nodules with halo sign 2 cases, cavity 2 cases.The occurrence rates of various signs in 30 cases were as follows, the sign of tree in bud was 33.3%, bronchial stenosis 20%, bronchiectasis 33.3%, ground-glass opacity 30%, acinar nodule 40%, nodular lesion 46.6%, halo sign 53.3%,cavity 40%.Conclusion The main HRCT signs in the patients with invasive pulmonary aspergillosis includes tree in bud, bronchial stenosis, bronchiectasis, ground-glass opacity, acinar nodules, nodal lesions,pulmonary cavity and halo sign.The signs of bronchiectasis with tree in bud sign, acinar nodule and halo sign in the HRCT images are highly specific in the diagnosis of invasive pulmonary aspergillosis.

OBJECTIVE: To observe normal and abnormal findings of foramina within internal auditory canal (IAC) fundus with Virtual Endoscopy of multisection helical Computed Tomography. METHOD: CT scanning of temporal bone was undergone in 25 volunteers (50 ears) in the normal group, in 8 cases (13 ears) with foramina hypoplasia within IAC fundus which were shown on CT and MRI images. CT virtual endoscopy (CTVE) findings were observed in the normal and abnormal groups. The lower threshold value was 900-1200 HU, the upper value was 3,071 HU in CTVE definitions. RESULT: The shape and position of foramina within IAC fundus were shown on the CTVE image, 50 foramina within IAC fundus were shown in all normal cases. In abnormal group, 9 ears were shown as IAC fundus disorder and foramina absent, only 1 foramina was shown in 1 ear, 2 foramen in 4 ears, 3 foramen in 2 ears, 4 foramen in 2 ears; Abnormal shape of cochlear nerve foramina was seen in 4 ears. Other malformations were also shown, including IAC malformations in 3 ears and inner ear malformations in 8 ears. CONCLUSION CTVE is useful to show the shape and position of normal foramina and pathological changes in the patients with foramina hypoplasia within IAC fundus.
Adolescent ; Adult ; Case-Control Studies ; Child ; Child, Preschool ; Cochlear Nerve ; abnormalities ; diagnostic imaging ; Ear Canal ; abnormalities ; diagnostic imaging ; Ear, Inner ; abnormalities ; diagnostic imaging ; Female ; Hearing Loss, Sensorineural ; congenital ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Tomography, Spiral Computed ; methods ; Young Adult

OBJECTIVE: To investigate the CT virtual endoscopy (CTVE) shows the display method of the normal structure of the middle ear, and evaluation of middle ear disease, particularly in the value and significance of the connection status of the ossicular chain, established display ossicular chain and middle ear structure methods. METHOD: Volume scanning with a spiral CT unit was performed in forty normal cases and thirty patients with suspected lesions of middle ear. Respectively, with Germany's Siemens (Siemens SOMATOM Sensation 16) spiral CT the Inner Ear scanner patients with axial scanning, reconstruction of the original image, the software selected Fly-through A, B, C the point approach CTVE imaging studies. Focus ossicular chain connection status, and chronic otitis media shown the results of surgery in exploratory image control. RESULT: Normal group CTVE in the hammer bone, incus promontory, facial nerve, the lateral semicircular canal display rate was 100%; stapes, the two arch of the display rate in three display levels, respectively, to 57.5%, 70.0%, 97.5%; round window, oval window was 90.0%, 93.0%, 97.5%. Ossicular injury, displacement, interruption, deletion, deformity in cases of otitis media, trauma, temporal bone malformations. CONCLUSION CTVE link relations between the three ossicles (such as interrupt, etc.) have a certain advantage. By choosing the appropriate approach, CTVE has a considerable advantage in the ossicles and their connections, relations as well as pathological state. By comparing CTVE in three different display levels,the technique of CTVE is considered to be an advantageous supplement of tomography.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Ear Ossicles ; diagnostic imaging ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Temporal Bone ; diagnostic imaging ; Tomography, X-Ray Computed ; Young Adult

Objective:To summarize the clinical and imaging presentations of stapical footplate hernia related to inner ear malformation (SFH-Re-IEM).Methods:The clinical and imaging data of 19 patients (24 ears) with SFH-Re-IEM from Shandong Provincial ENT Hospital between June 2014 to June 2022 were retrospectively analyzed. The clinical presentations and headache and the high resolution CT (HRCT) and MRI findings including associated inner ear malformation (IEM) type, internal auditory canal (IAC) malformation, bony defect of the stapical footplate, the extent, margin, density and signal of the herniation cysts, the density and signal of ipsilateral intratympanic, cochlear osseous labyrinthitis were recorded.Results:Among 19 SFH-Re-IEM patients, including 14 males and 5 females, 3 (1, 12) years old. All of the affected ears presented sensorineural or mixed hearing loss, 1 ear for moderate, 7 ears for severe and 16 ears for extremely severe. Besides this, the vertigo in 1 case, otalgia and ear fullness in 2 cases were found, and the others were detected accidentally. Among 24 ears with SFH-Re-IEM, 9 ears (37.5%) consisting with incomplete partition type Ⅰ, 3 ears (12.5%) with common cavity, 7 ears (29.2%) with cochlear aplasia, 3 ears (12.5%) with cochlear dysplasia type Ⅱ, and 2 ears (8.3%) with Mondini deformity were found respectively. Four ears (16.7%) were associated with IAC enlargement and the bony defect of IAC fundus, 19 ears (79.2%) were accompanied with dysplasia in the IAC fundus. In all the 24 ears with SFH-Re-IEM, the focal bony defect of the affected stapical footplate and the hemispherical soft-tissue-density herniating cysts protruding into the tympanium were presented on HRCT, and the herniating cysts presenting the cerebrospinal fluid-like signal with the well-defined margin and the ipsilateral normal tympanium were shown on the MRI hydrographic sequence. Two ears underwent the perilymphaticum gadolinium based on MRI, which demonstrated the hypersignal gadolinium in the perilymphatic space entered into the herniating cysts. Two ears were accompanied with the cochlear osseous labyrinthitis.Conclusion:The ears with IEM-Re-SFH usually present the serious hearing loss. The ipsilateral severe IEM, focal bony defect of the stapical footplate and perilymph herniating are characteristic imaging appearances.

Objective:To summarize the imaging presentations of the fallopian canal cerebrospinal fluid leaking (FCCFL).Methods:The high resolution CT (HRCT)and MRI materials of 4 patients (4 ears) with FCCFL confirmed by surgery between August 2016 to November 2023 were retrospectively analyzed. Among these, there were 2 males and 2 females, their ages ranged from 6 to 69 years.Results:All of the FCCFL were unilateral, including 2 on the left and 2 on the right.Clinically, the patients with FCCFL suffered from clear nasal fluid flow, ear tightness, and hearing loss. On CT, all of the affected ears were depicted markedly dilatation of the proximal portion of fallopian canal(FC), the labyrinthine segment and geniculate fossa were involved in 4 cases, and involvement of tympanic segment in 1 case at the same time. The geniculate fossa in the affected side were significantly enlarged, protruding upwards into the tympanic cavity, with one case simultaneously involving the cochlea. On MRI, the hyposignal on T 1WI and hypersignal on T 2WI or water sequence like cerebrospinal fluid (CSF) were shown in the enlargement FC, without diffusion restriction, and non-enhancing with administration Gadolinium contrast.CSF-like signal effusion was shown in all of the affected tympanum, of which, the CSF-like signal effusion was demonstrated in the area along the superficial petrosal nerve, the right pterygopalatine fossa and the parapharyngeal space. The adjacent intracranial meninges were presented thickening in 3 cases. Conclusion:The imaging appearances of FCCFL present some characteristics:on HRCT, the proximal portions of the affected FC depicts markedly enlargement,especially the geniculate fossa.While they present CSF-like signal, no diffusion restriction, and no enhancement administration, Gadolinium contrast on MRI, accompanying the CSF-like signal effusion in the affected tympanum.

Objective:To summarize the HRCT and MRI appearances of stapical footplate fistula related to inner ear malformation (SFF-Re-IEM).Methods:The HRCT and MRI materials of 48 cases (53 ears) SFF-Re-IEM were retrospectively analyzed. Among them, 25 SFF-Re-IEM ears were confirmed by surgery. Their CT and MRI findings including associated IEM type, internal auditory canal (IAC) malformation, tympanic fluid, its density and signal features, and accompanied labyrinthitis were recorded.Results:Among 48 cases (53 ears) with SFF-Re-IEM, 17 ears with incomplete partition type Ⅰ, accounting for 32.1%, 13 ears with common cavity for 24.5%, 13 ears with cochlear aplasia for 24.5%, 7 ears with cochlear dysplasia Ⅱ for 13.2%, and 3 ears with Mondini for 5.7%,were found respectively. 94.3% of them were associated with a defect or dysplasia in the found of the IAC. They were divided into 4 types according to the intact of the stapical footplate and accompanied CSF otorrhea: 22 ears were diagnosed as the stapical footplate leaking, of them, 2 ears might come from the stapical footplate bony defect, 6 ears were from the stapical footplate hernia. 1 ear belonged to the peristapical footplate leaking. 30 ears with the isolated the stapical footplate hernia were another found. The bony defect in 2 ears with the stapical footplate bony defect were not presented on CT and MRI.The focal bony defect of the affected stapical footplate of 36 ears with the stapical footplate hernia were demonstrated, which presented the hemispherical protruding into the tympana, the soft-tissue density on CT, and CSF-like signal on the MR heaved-T2WI images. Among 22 ears with the stapical footplate leaking, their imaging appearances varied from the different amount of the leaking CSF. Besides the focal bony defects of the affected stapical footplates, there were much more CSF-like density or signal in the ipsilateral tympanic cavity in 17 affected ears connecting with the vestibule through the defect area. In the CSF leaking ears with less CSF leaking in 5 ears, the CSF-like cysts like SFH were shown on the stapical footplate defect area, but their outer edges were irregular, and the CSF-like signal scattering in the tympanic cavity did not connect with the protruding cysts at the stapical area.Conclusion:The variable appearances of the SFF-Re-IEM ears based on the different subtypes are its characteristic HRCT and MRI appearances. This is helpful for the SFF-Re-IEM diagnosing to grasp its imaging features.