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PP004

DYNAMIC IMAGING OF THE EUSTACHIAN TUBE DURING SWALLOWING USING A 320-ROW AREA DETECTOR CT (4DCT) SYSTEM

Wednesday, 28 September, 2011 - 12:20
Board 1

DYNAMIC IMAGING OF THE EUSTACHIAN TUBE DURING SWALLOWINGUSING A 320-ROW AREA DETECTOR CT (ADCT,4DCT) SYSTEMSince impairment of functions of Eustachian tube canlead to various diseases of the middle ear, somorphological and functional evaluation of theEustachian tube is clinical importance.We are using a 320-row Area Detector CT scanner(ADCT,4DCT) to analyse a movement of theEustachian tube. We have succeeded in visualizingmovement of the Eustachian tube during swallowingusing ADCT. I would like to present for the first timesome truly innovative dynamic images.WHAT IS AN ADCT or 4DCT ? ;In current mainstream multislice CT, a multi-row detector isrotated continuously while the patient slides through thegantry.This newly developed Area Detector CT (ADCT) systemhas a wide-area detector (0.5*320=160mm) and cancover a wider range than ever before in a single rotation.So there are no time differences in the acquired data overthe entire scan range, and acquisition is completed instantly.And with continuous rotation permits consecutive threedimensionaldynamicimage data to be acquiredover time and this isreferred to as "4DCT".We used the ToshibaAquilion ONE, the onlyscanner that supports4DCT.We scanned the region from the Eustachian tube to theneck continuously for approximately 3 seconds duringswallowing and created Eustachian tube images.•120kV, 120-150mA, 0.5mm, 280-320rows,0.35sec/r,9rot(3sec)•MPR(MultiPlannerReconstruction) and 3DCTimages were observed•Make consective images every 0.1 second•5 volunteers were scannedWe successfully visualized opening of the cartilaginous portion of the Eustachian tube for approximately 0.4seconds during the pharyngeal period. In the following figures, all of the Eustachian tube images are synchronizedwith the swallowing image on the upper. We show an image of every 0.1 second that continued in terms of time.The Eustachian tube of the part which we showed at a “ “ is observed to open.In the axial images, you can see the process of opening of the cartilaginous portion of the Eustachian tube during the pharyngeal period ofswallowing about 0.4 seconds. In the sagittal images at 4 locations, the opening can be seen at each location. You can see that thecartilaginous portion of the Eustachian tube opens while twisting by a half turn. In the virtual endoscopic images and air-mold images,the process of opening can be observed more clearly. Morphological assessment of Eustachian tube movement during swallowing shouldbe possible by detailed analysis of the movement at each location.As I have shown, we have succeeded in obtainingspatially and temporally continuous dynamic images ofthe Eustachian tube using a newly developed 320-rowArea Detector CT (4DCT) system.We were able to observe the movements of theEustachian tube during swallowing in synchronizationwith swallowing motion.More detailed image analysis will lead to furtheradvances in morphological studies.The technique we employed in this study has greatpromise as a new examination method that combinesmorphological and functional studies. The Eustachiantube is a very significant structure in patients with middleear diseases. 4DCT is expected to be an innovative toolfor assessing pathologic changes in diseases related toEustachian tube dysfunction.#1. Yoshioka SA., Analysis of the Morphological andFunctional Characteristics of the Eustachian Tube UsingMultislice CT and 320-row Area Detector CT., NipponJibiinkoka Gakkai Kaiho 114:547-556,2011#2. Yoshioka SA et al., Visualization of an Eustachiantube using a 1-mm,8-row multislice CT scanner duringValsalva maneuver., Otol Jpn 13(2):111-117,2003Contact me:syosioka@fujita-hu.ac.jp

 

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