螺旋CT多平面重建和仿真内镜技术对腺样体肥大的诊断价值  

The Diagnostic Value of CT Multiple Planar Reconstruction and Virtual Endoscopy in Treating the Adenoid Hypertrophy

作　　者：栾海[1] 李宏伟[2] 王春生[1] 王微[2] 

机构地区：[1]中国人民解放军第281医院放射科,河北省秦皇岛市066100 [2]中国人民解放军第281医院五官科

出　　处：《中国全科医学》2010年第30期3464-3467,共4页Chinese General Practice

摘　　要：目的探讨螺旋CT多平面重建和仿真内镜技术对腺样体肥大的诊断价值。方法选取32例腺样体肥大患者进行螺旋CT多平面重建,对腺样体厚度(A)/鼻咽腔宽度(N)比值、鼻咽通道宽度(D)及高度(H)进行测量。并进行仿真内镜检查,构建重组图像,观察后鼻孔、鼻中隔及后鼻孔阻塞程度。再将螺旋CT检查情况与鼻内镜检查结果对比。结果螺旋CT多平面重建图像显示腺样体及临近解剖结构清晰,可测定A/N、鼻咽通道D及H。32例患者中,腺样体A/N≤0.6有9例,0.6<A/N<0.7有17例,A/N≥0.7有6例,测量结果与鼻内镜或术中情况符合。仿真内镜后视位可见鼻中隔及后鼻孔24例,前视位见腺样体肥大占据后鼻孔,呈Ⅰ°阻塞3例,Ⅱ°阻塞6例,Ⅲ°阻塞16例,Ⅳ°阻塞7例,与鼻内镜检查结果进行一致性检验,发现两种检查结果基本一致(χ2=4.000,P=0.261),Kappa值为0.806。结论螺旋CT多平面重建和仿真内镜技术不仅可以为临床提供准确的腺样体测量数据,还能对鼻咽部进行全面的、仿真地观察,对腺样体肥大的诊断具有很高的临床应用价值。Objective To investigate the diagnostic value of MPR and CTVE in treating the adenoid hypertrophy.Methods 32 cases of adenoid hypertrophy were examined by MPR.After the measurement of their adenoids A/N ratio,the nasopharyngeal passages＇ width D and height H,CTVE detection was conducted to construct an image reformation.Then observe the posterior naris and nasal septum＇s extent obstruction,and compare the results of the spiral CT examination with that of the nasal endoscope.Results MPR image showed clear adenoids and adjacent anatomical structure,which can be used to measure the adenoids A/N ratio,and the nasopharyngeal passages＇ height H and width D.Among the 32 cases of adenoids,9cases with A/N≤0.6,17 cases with 0.6A/N0.7,and 6 cases with A/N≥0.7.This result was consistent with that of NE or CTVE.The inspection at the rear of CTVE showed 24 cases of nasal septum and posterior naris;and the front one showed that the posterior naris was occupied by the adenoid hypertrophy with 3 cases of Ⅰ° obstruction,6 cases of Ⅱ°obstruction,16 cases of Ⅲ° obstruction,7 cases of Ⅳ° obstruction.After the statistical consistency analysis between the results of CTVE and NE,Mate χ2 Test χ2=4.000,P=0.261,and both of them showed a substantial result.Consistency test Kappa=0.806（0.75）.Two groups＇ statistics had a good consistency,and the diagnosis with various methods had no significant difference.Conclusion MPR and CTVE technology can not only provide accurate adenoid data for the clinical research,but can be also used to observe the cavum nasopharyngeum comprehensively and virtually,which shows a high value in the clinical diagnosis of adenoid hypertrophy.

关 键 词：腺样体肥大 螺旋CT多平面重建 螺旋CT仿真内镜 鼻咽 诊断 

分 类 号：R765.2[医药卫生—耳鼻咽喉科]