BACKGROUND Central skull-base osteomyelitis (CSBO) represents a life-threatening complication of external ear canal infection. Computed tomography (CT) and magnetic resonance imaging (MRI) play key roles in assessment of CSBO progression. METHODS Twelve patients with CSBO were included in a retrospective clinical study. In total, 62 scans (30 CTs and 32 MRIs) were performed to evaluate the extent of inflammatory changes. The scans were read independently by two radiologists specialised in imaging of the head and neck. The regions under the skull base were specified using the online Anatomy Atlas of the skull base. To clarify the timeline, the time period was divided into four parts, and inflammatory changes in the skull-base regions were tracked. Data were statistically analysed. RESULTS In early stages of the disease, CT scan detects inflammatory changes closely related to the stylomastoid foramen and medially to the posterior belly of the digastric muscle, changes which have been proved to be crucial for the diagnosis of CSBO. Later the infection spreads to the contralateral side causing demineralisation of the bones. CONCLUSION Imaging methods play a crucial role not only in establishing the diagnosis, but also in anticipating the direction of infection spread underneath the skull base.

中文翻译：

---

感染途径在中枢颅骨性骨髓炎中传播，以及CT和MRI扫描的诊断作用。

背景技术中枢颅骨性骨髓炎（CSBO）代表外耳道感染的危及生命的并发症。计算机断层扫描（CT）和磁共振成像（MRI）在评估CSBO进展中起关键作用。方法回顾性临床研究纳入12例CSBO患者。总共进行了62次扫描（30次CT和32次MRI）以评估炎症变化的程度。两名专门从事头部和颈部成像的放射线医师独立读取扫描结果。头骨底下的区域是使用头骨底下的在线解剖图集指定的。为了弄清时间表，将时间段分为四个部分，并跟踪了颅底区域的炎症变化。数据进行统计分析。结果在疾病的早期阶段，CT扫描可检测到与茎突肌孔以及与腹膜后腹内侧密切相关的炎症变化，这些变化已被证明对CSBO的诊断至关重要。后来，感染扩散到对侧，导致骨骼脱矿质。结论影像学方法不仅在建立诊断中起着至关重要的作用，而且在预测感染在颅底下方传播的方向方面也起着至关重要的作用。