口服对比剂法CT检查显示下咽部解剖结构观察分析  

Clinical values of CT scan with oral contrast agent for displaying the anatomical structure in hypopharynx

作　　者：张继扬[1] 万业达[1] 张琳[1] 何珍[1] 刘竞艳[1] 胡鹏[1] 何岸苇[1] 蔡华琦 李艳[1] 刘立艳[1] 

机构地区：[1]天津市天津医院,天津300210

出　　处：《中国临床医学影像杂志》2016年第1期6-9,18,共5页Journal of China Clinic Medical Imaging

摘　　要：目的 :对照分析常规螺旋CT扫描和口服对比剂后螺旋CT扫描双侧梨状窝和环杓后区下咽腔解剖结构的显示及临床意义。方法:回顾性分析60例常规颈椎螺旋CT扫描患者资料,观察双侧梨状窝和环杓后区下咽腔显示率。另选取60例门诊欲行颈椎螺旋CT扫描患者,口服配置好的硫酸钡和欧乃派克混悬液对比剂后行颈椎螺旋CT扫描,观察双侧梨状窝和环杓后区下咽腔显示率,并对图像评定等级。上述两组病例分别由2名放射科副主任医师和2名耳鼻喉科副主任医师独立阅片,并将两种方法进行统计学分析。结果:常规螺旋CT扫描左、右梨状窝显示率分别为70%和65%;杓状软骨水平和环状软骨水平下咽腔显示率分别为43.3%和28.3%。口服混悬液对比剂后螺旋CT扫描左、右梨状窝显示率91.7%(55/60)和90.0%(54/60);杓、环后区下咽腔显示率为93.3%(56/60)和96.7%(58/60)。两种方法显示双侧梨状窝、杓状软骨后区、环状软骨后区下咽腔比较,P<0.05,差异具有统计学意义。结论 :口服混悬液对比剂后螺旋CT扫描可以勾勒出下咽的解剖结构,直接显示梨状窝和环杓后区下咽腔的形态,弥补了临床喉镜的不足,为疾病的早期发现和术前分期提供可靠的影像学依据。Objective: To investigate the clinical value of spiral CT scan with oral contrast agent for displaying the anatomical structure of postcricoarytenoid region and piriform sinus region. Methods: The CT images of 60 patients after conventional spiral CT scan were reviewed and the CT images of 60 patients after spiral CT scan with oral contrast agent were analyzed. The anatomical structures of postcricoarytenoid region and piriform sinus region were observed. The demonstration rate was calculated and the image rating was evaluated by two radiologists and two otolaryngology doctors with a double-blind method. Chi-square test was adopted in statistical analysis. Results: In conventional spiral CT scan, the air occurrence rates were 65% and 70% in the right and left sinuses respectively. The detection rate of hypopharyngeal cavity was 43.3% in the arytenoid cartilage level and was 28.3% in the cricoid cartilage level. After orally contrasted spiral CT scanning, the left and right piriform sinus occurrence rates were 91.7%(55/60) and 90%(54/60). The detection rates of hypopharyngeal cavity in the arytenoid and cricoid cartilage level were 93.3%(56/60) and 96.7%(58/60) respectively. P<0.05 was considered statistically different. Conclusion: CT scans with oral contrast agent can contour the profile of hypopharynx and clearly display the anatomical structure of the postcricoarytenoid region and piriform sinus region in closed state. It can cover the shortage of clinical laryngoscope and provide objective images for detecting early diseases and confirming the surgical staging.

关 键 词：下咽 体层摄影术 螺旋计算机 造影剂 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学] R816[医药卫生—基础医学]