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文献速递神经头颈CT

光子计数探测器CT在体可视化圆窗龛盖膜

In Vivo Visualization of the Round Window Niche Veil using Photon-Counting Detector CT.
PubMed 文献 · AJNR Am J Neuroradiol · 2026-05-07

本研究纳入80例颞骨光子计数探测器CT（PCD-CT）扫描，由两名神经放射科医生独立评分，评估圆窗龛盖膜（RWNV）的在体可视化能力。结果显示PCD-CT可在43.8%的耳中显示部分或完全RWNV，圆窗清晰时48.8%的耳未显示RWNV，7.5%的耳圆窗龛完全混浊而未显示RWNV。结论认为PCD-CT可能有助于判断圆窗龛是否通畅。

要点

  • PCD-CT可显示部分或完全圆窗龛盖膜（RWNV），提示圆窗龛可能不通畅。
  • 圆窗清晰时近半数耳未显示RWNV，需注意假阴性可能。
  • 圆窗龛完全混浊时无法评估RWNV，报告应描述为显示不清。

核心结论

  • PCD-CT可在体显示圆窗龛盖膜，可能有助于判断圆窗龛是否通畅。

研究设计与样本

  • 研究纳入2025年4月至6月间的80例颞骨PCD-CT扫描，由两名经验丰富的神经放射科医生独立阅片并采用4级评分法评估RWNV。

关键影像表现/征象

  • PCD-CT在43.8%的耳中显示部分或完全RWNV。
  • 圆窗清晰时，48.8%的耳未显示RWNV。
  • 7.5%的耳表现为圆窗龛完全混浊，未显示RWNV。

诊断标准与关键数值

  • 评分标准：1分为部分盖膜伴或不伴液体，2分为完全盖膜伴或不伴液体，3分为无圆窗龛盖膜，4分为显示不清、圆窗龛完全混浊。

临床应用与阅片要点

  • 阅片时应关注圆窗龛区域，按4级评分描述盖膜显示情况，辅助评估经鼓室给药的通畅性。
  • 圆窗清晰时仍需警惕RWNV未显示的可能，避免漏诊。
  • 圆窗龛完全混浊时无法评估盖膜，报告应注明显示不清。

局限性

  • 原文未报告样本量估算依据及单中心或多中心设计。
  • 研究仅纳入80例颞骨，为回顾性设计，可能存在选择偏倚。

以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。

英文原文（摘要）· 点击展开

BACKGROUND AND PURPOSE: The round window niche veil (RWNV) is a potential anatomic barrier at the round window niche due to thickened middle ear mucosa or fibrosis that either partially or completely covers the niche and may prevent intratympanic medication efficacy. This study aimed to characterize the in vivo capability of photon-counting-detector (PCD) CT to visualize the RWNV.

MATERIALS AND METHODS: 80 PCD-CT temporal bones were included in the study between April and June 2025. Two experienced neuroradiologists independently reviewed each scan and assigned each with one of the following scores: 1: partial veil seen with or without fluid, 2: complete veil seen with or without fluid, 3: no round window niche veil, and 4: not seen, complete round window niche opacification.

RESULTS: PCD-CT visualized either partial or complete RWNV in 43.8% of ears. Further, the RWNV was not visualized in 48.8% of ears when the round window was clear. In 7.5% of ears, complete opacification of the round window niche was noted without visualization of a RWNV. The presence or absence of RWNV visualization demonstrated high inter-rater reliability with unweighted kappa of 0.81 (0.69, 0.92).

CONCLUSIONS: PCD-CT may visualize the round window niche veil in vivo and may be helpful in determining if the round window niche is patent.

来源：AJNR Am J Neuroradiol，查看原文。版权归原作者所有。

引用

  1. Neuberger KM, Farnsworth PF, Lane JI, et al. In Vivo Visualization of the Round Window Niche Veil using Photon-Counting Detector CT. AJNR Am J Neuroradiol. 2026. PMID: 42097845. doi:10.3174/ajnr.A9399
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供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。