Jpn J Radiol (2010) 28:637–648
DOI 10.1007/s11604-010-0479-0
PICTORIAL ESSAY
Temporal bone anatomy: correlation of multiplanar reconstruction
sections and three-dimensional computed tomography images
Naoko Fujii · Yoshitaka Inui · Kazuhiro Katada
Received: March 25, 2010 / Accepted: June 15, 2010
© Japan Radiological Society 2010
Abstract Two axial and coronal section planes are com-
monly used for a conventional computed tomography
diagnosis of the temporal bone. In recent years, sagittal
and oblique section planes have been reformatted using
high-resolution multiplanar reconstruction (MPR).
Detailed three-dimensional (3D) images are also
employed. To understand the 3D structure of the small,
complicated temporal bone, we compared common
angle MPR section planes with 3D images. We also
suggest four-section planes, which are optimal for
observing the ossicular chain.
Key words Temporal bone · Ossicles · Anatomy ·
Multiplanar reconstruction · Three-dimensional
computed tomography
Introduction
Recent advances in multislice computed tomography
(MSCT) have enabled the acquisition of high-resolution
isotropic volume data.1 Concurrent development of
N. Fujii (*) · Y. Inui · K. Katada
Department of Radiology, Fujita Health University School of
Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake 470-1192,
Japan
Tel. +81-562-93-9259; Fax +81-562-95-2253
e-mail: nfujii@fujita-hu.ac.jp
The study discussed in this article was reported at a meeting of the
European Congress of Radiology in 2007 (ECR 2007, Educational
Exhibit, Electronic Poster Presentation: C-478, Head and Neck).
It has not been published elsewhere.
image generation and display technology has made it
possible to generate detailed three-dimensional com-
puted tomography (3D-CT) images of the small, com-
plicated structure of the temporal bone. The section
plane of any angle can be easily shown by sophisticated
multiplanar reconstruction (MPR). Axial and coronal
section planes are commonly used for CT diagnosis of
the temporal bone; and, in recent years, sagittal and
oblique section planes have also been used.2 Therefore,
it has become more important to understand 3D
anatomy.
We reviewed cross-sectional and 3D imaging of the
temporal bone and compared common angle MPR sec-
tions and 3D images. As the ossicular chain and inner
ear are arranged parallel to the longitudinal axis of the
temporal bone, coronal and sagittal planes in reference
to the anthropologic baseline cut these structures
obliquely. We demonstrated a method for observing the
entire ossicular chain by reformatting four section planes
sequentially, which is optimal for viewing the ossicles.
Cross-sectional imaging of temporal bone
After acquisition of data with the thinnest slice, high-
resolution CT (HRCT) of the temporal bone is gener-
ated using a dedicated algorithm. Conventionally, axial
and coronal section planes have been used, with 0° or
30° axial and 70° or 105° coronal section planes being
the standard angles in reference to the anthropologic
baseline, which is defined as the plane intersecting the
inferior orbital rim and the superior margin of the exter-
nal auditory canal. These angles were recommended by
Chakeres and Spiegel in 1983 when HRCT was first
introduced.3 As direct scanning was used at that time, a
638
low radiation dose to the lens, visualization of small
bony structures, technical factors, ease of patient posi-
tioning, and interpretation of the images were consid-
ered when determining the angles. Although direct
sagittal scanning was reported in 1998,4 imaging facilities
were limited as a special head holder for temporoman-
dibular joint imaging was required. In 1992, a modified
baseline parallel to the hard plate that had smaller scan
coverage and lower radiation dose to the lens was pro-
posed,5 and its use became widespread. Progressing into
the MSCT scanner era, acquisition of high-resolution
isotropic volume data1 and an advanced MPR technique
have made it possible to use not only axial, coronal, and
sagittal sections but also an oblique section for depicting
objects.6
Three-dimensional CT imaging of temporal bone
The 3D-CT images of the temporal bone were first
reported in 1990.7,8 After the introduction of helical CT
scanners, 3D-CT images of the small ossicles and inner
ear anomalies were reported.9 Recently, MSCT scanners
have been widely employed and 3D-CT images gener-
ated using various 3D reconstruction methods including
volume rendering, maximum intensity projection, and
virtual endoscopy. Subsequent application to high-qual-
ity 3D-CT images of the temporal bone, ossicles, and
inner ear became popular for clinical and educational
purposes.10–12
MSCT data acquisition and postprocessing
The source data of MPR and 3D-CT were obtained from
a single volunteer who gave informed consent. This
research was conducted to the highest ethical standards
as well as conforming to the provisions of the Helsinki
Declaration of 1975, as revised in 2004. CT scanning was
performed using the four 0.5-mm detector rows at the
center of the detector equipped with a 16-row MSCT
scanner (Aquilion Multi; Toshiba Medical Systems,
Otawara, Japan). The scanning parameters were 135 kV,
150 mA, helical pitch 2.5 (pitch factor 0.625), and table
speed 1.5 mm/1.5 s/1 X-ray tube rotation. Nearly isoto-
pic voxel data (0.5 × 0.5 × 0.5 mm) can be acquired by
CT at a slice thickness of 0.5 mm, a matrix size of 512 ×
512, and an acquisition field of view (FOV) of 240 mm.
Scanning was performed parallel to the infraorbitome-
atal line. The plane corresponding to the scan angle
passed through the superior margin of the external
auditory canal and infraorbital rim, overlapping the
anthropological baseline. In addition, this plane was
Jpn J Radiol (2010) 28:637–648
Fig. 1. Scan angle. A The plane corresponding to the scan angle
passed through the superior margin of the external auditory canal
and infraorbital rim (arrows), overlapping the anthropological
baseline. B In addition, this plane was approximately parallel to
the hard plate (arrowheads) and corresponded to the modified
baseline
approximately parallel to the hard plate and corre-
sponded to the modified baseline (Fig. 1).
Thin-slice images for MPR and 3D-CT of the right ear
were generated using a high-definition algorithm with a
reconstruction FOV of 90 mm, slice thickness of 0.5 mm,
and reconstruction interval of 0.1 mm. Preinstalled CT
scanner software and a workstation (M900 Quadra;
Ziosoft, Tokyo, Japan) were used for MPR and 3D-CT,
respectively. This workstation can simultaneously access
eight volume data sets to create eight 3D images and,
furthermore, can select the necessary 3D images to display
an overlay image. Surface, bone, mastoid cavity, ossicles,
inner ear, facial nerve, tympanic muscles, and section
planes were created using a volume rendering method.
The surface and ossicles were generated from data with
CT values of −300 HU or more. The bone was generated
with 500 HU or higher, and the mastoid cavities were
generated with −800 HU or less. The other structures
were generated with window level (WL) 0 HU/window
width (WW) 600 HU. To display the target structure,
surrounding unnecessary structures were manually
removed. The section planes were created from the data
block with all CT values. On the lateral image displayed
on the monitor, a 0°, 30°, 70°, or 105° line was drawn
around the superior margin of the external auditory canal,
and the thinnest possible plate was manually created
along the line. Each 3D image was colored, and display
parameters such as transmittance were finely adjusted.
Figure 2 shows 0° and 30° axial, 70° and 105° coronal,
and sagittal section planes on 3D-CT images.
3D-CT of temporal bone structures
The anatomy of the temporal bone has been described
in numerous anatomical textbooks, and a detailed expla-