3D image of the middle ear ossicles: three protocols of post-processing based on multislice computed tomography

Area of Science:

• Radiology and Imaging
• Otolaryngology
• Medical Visualization

Background:

• Accurate visualization of the ossicular chain is crucial for diagnosing middle ear pathologies.
• High-resolution computed tomography (HRCT) offers detailed anatomical imaging.
• Various 3D reconstruction techniques exist, each with potential strengths and limitations.

Purpose of the Study:

• To comparatively evaluate the diagnostic value of three HRCT-based 3D reconstruction protocols for the ossicular chain.
• To assess multiplanar reformation (MPR), volume rendering (VR), and shaded-surface display-based virtual endoscopy (SSD-based CTVE).
• To determine the most effective protocol for visualizing ossicular chain structures.

Main Methods:

• Review of HRCT scans from 32 human ears with normal audiograms and tympanograms.
• Reconstruction of ossicular chains using MPR, VR, and SSD-based CTVE protocols.
• Qualitative assessment using a 3-point scoring system and statistical analysis of visualization efficacy.

Main Results:

• All HRCT protocols visualized the ossicular chain, but SSD-based CTVE failed to image the footplate.
• MPR and VR were superior to SSD-based CTVE (P < 0.05) for overall ossicular visualization.
• VR demonstrated significantly better visualization of the malleus lateral process and stapes anterior crus/footplates compared to MPR and SSD-based CTVE (P < 0.05).

Conclusions:

• Volume rendering (VR) is a highly valuable protocol for 3D reconstruction of the ossicular chain.
• VR demonstrates superior efficacy in visualizing specific ossicular components compared to MPR and SSD-based CTVE.
• VR holds significant potential for enhanced medical education and clinical diagnosis of middle ear structures.