Comparison of measuring an area with a planimeter and by rectangular dimensional methods

Abstract

We have developed a system that measures the volume of air cells in the temporal bone through computerized digital processing of high-resolution CT images. By using this method, the volume of pneumatization was measured, and the results were compared with the measured area of pneumatization obtained from two conventionally used simple ear X-ray methods (the planimeter and rectangular dimensional methods). A total of 57 ears, from 34 subjects, confirmed as normal by CT were examined. The average volume of pneumatization measured on CT images was 5.97 +/- 4.15ml, and the average areas of pneumatization measured by the planimeter and rectangular methods were 9.08 +/- 5.64 and 17.39 +/- 9.77 cm2, respectively. Graphically, when the volume of pneumatization was plotted on the Y axis and the planimeter-measured area of pneumatization on the X axis, a regression formula of Y = 0.651X + 0.054 was obtained, with a correlation coefficient of 0.89. With the volume of pneumatization plotted on the Y axis and the rectangular-dimensional-measured area of pneumatization on the X axis, the regression formula was Y = 0.375X - 0.559, with a correlation coefficient of 0.88. Both these correlation coefficients were considered high. Furthermore, 3D models of the air cells in the temporal bone were created and compared for patients with high and low correlations. In order to capture the morphological characteristics of these 3D models, they were examined from four different angles (lateral, upper lateral, anterior lateral and upper medial). The results showed that regardless of whether air-cell growth was present in the direction of the apex partise petrosae in patients with a low correlation coefficient, such growth played a major role in the degree of the correlatiton. Future studies will be required to clarify this point, though it can already be said that 3D models are indispensable for studying the air cells in the temporal bone. When we compared the volume and area of pneumatization in the temporal bone at different CT cross-sections, we found correlation coefficients in the vicinity of the canalis semicircularis lateralis of about 0.9 or higher. A statistical comparison of correlation coefficients for the CT, planimeter, and rectangular dimensional methods, made by using the CT cross-section with the highest coefficient, found a significant difference between the CT method and the other two methods (p < 0.05). In other words, the volume of pneumatization can be estimated more accurately with CT images than with simple ear X-rays.