Radiology, Vol 147, 743-748, Copyright © 1983 by Radiological Society of North America
Temporal bone disease: a comparison between high resolution computed tomography and pluridirectional tomography
C Virapongse, M Sarwar, EL Kier, C Sasaki and H Pillsbury
Sixty-five patients with suspected ear disease were examined with CT, and
abnormalities were detected in 42 of them; 58 of these patients also had
pluridirectional tomographic examinations. Eighteen of the patients in whom
abnormalities were detected underwent exploratory surgery. CT was useful in
the diagnosis of tympanic membrane swelling, fluid in the middle ear,
cholesteatoma, granulation tissue, and adhesions. The superior contrast
resolution of CT allowed for the visualization of ossicles when they were
surrounded by an inflammatory mass or by blood. In trauma cases, axial
images facilitated visualization of longitudinal fractures, which
frequently pass through the geniculate ganglion of the facial nerve. CT and
pluridirectional tomography were comparable in the demonstration of disease
that involved the mastoid air cells, although fluid in air cells was more
easily demonstrated by CT. Pluridirectional tomography was superior to CT
in the demonstration of bone destruction; CT, however, was more sensitive
in the diagnosis of lateral semicircular canal fistula. Based on this
analysis, we recommend that these two modalities be used in a complementary
fashion to evaluate suspected middle ear disease.
