正常成人上气道多层螺旋CT研究及临床价值  

MSCT in Upper Airway of Healthy Adult and Clinical Value

作　　者：郑文龙[1] 吴爱琴[2] 滕陈迪[1] 余振磊[1] 陈伟军[3] 余清[4] 

机构地区：[1]温州市第二人民医院放射科,325000 [2]温州医学院附属第二医院放射科 [3]温州市第二人民医院五官科,325000 [4]温州医学院公共卫生学院

出　　处：《医学研究杂志》2011年第9期119-122,共4页Journal of Medical Research

基　　金：温州市科技计划项目(Y20090364)

摘　　要：目的探讨正常成人不同呼吸时相上气道CT影像形状和各平面测量参考值。方法搜集无睡眠呼吸疾病史健康成人65例,于清醒状态下行多层螺旋CT仰卧位扫描,扫描范围从蝶窦中部至气道食管分界点水平。每位研究对象均扫描平静呼吸、深吸气末、深呼气末及闭口堵鼻深吸气(Müller's)4个呼吸时相,分别测量鼻咽区、腭咽区、舌咽区和会厌区的前后径、左右径、截面积,软腭的长径和厚径,鼻咽顶壁的厚径,以单侧95%可信区间确定各测量指标参考值,采用仿真内镜重建观察上气道形状。结果上气道整体基本形状呈两端略宽椭圆柱形,左右横径大于前后矢状径。各部位咽腔截面形状有所不同,仿真内镜能清楚观察腔内结构。不同呼吸时相各测量径线数值无统计学差异,并确定各径线的正常值范围。结论正常成人上气道CT影像形状和各部位测量参考值的确定为临床正确诊断OSAS提供了客观依据。Objective To investigate the CT shape and reference value of measurement on every plane of upper airway at different respiratory phase in healthy adults. Methods 65 cases of healthy adults without any apnea or snoring symptoms were scanned by MSCT from middle sphenoid to cut - off point level of esophagus and airway at awake state in supine position. Four respiratory phases of calm res- piration,deep inspiration,deep expiration and Miillers action were scanned in every case. The anteroposterior diameter, transverse diame- ter, cross - sectional area at nasopharyngeal,velopharyngeal,glossopharyngeal and epiglottis area,the length and thickness of soft palate, the nasopharynx top wall were measured. The normal extent of every variable was determined by unilateral 95% confidence interval. The shape of upper airway was observed by CT virtual bronchoscopy （ VE）. Results The base shape of upper airway was elliptic with slightly wider at both ends and the transverse diameter was larger than anteroposterior diameter. The cross - sectional shape of each part of pharyn- geal was different. The cavity structure was clearly observed by VE. It had no statistical difference in the value of measured diameters at different respiratory phase,and the normal range of diameters were determined. Conclusion The determination of CT imaging shape and measuring reference value of upper airway in health adults can provide an objective evidence to correctly clinical diagnosis of OSAS.

关 键 词：上气道 解剖 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学]