甲状软骨钙化的高频超声研究在嗓音医学中的应用  

Application of high frequency ultrasound of thyroid cartilage calcification in phoniatrics

作　　者：赵新宇 王雪峰 郭照萌 杨育煌 骆冬梅 李胜 王鹏 ZHAO Xin-yu;WANG Xue-feng;GUO Zhao-meng;YANG Yu-huang;LUO Dong-mei;LI Sheng;WANG Peng(Department of Ultrasound,Longgang ENT Hospital of Shenzhen,Shenzhen 518172,Guangdong,China;Baogang NO.15 Median School,Baotou 014000,Inner Mongolia,China)

机构地区：[1]深圳市龙岗区耳鼻咽喉医院,广东深圳518172 [2]包钢十五中学,内蒙古包头014000

出　　处：《生物医学工程与临床》2021年第1期19-23,共5页Biomedical Engineering and Clinical Medicine

基　　金：深圳市龙岗区科技创新委基础研究项目(LGKCYLWS2018000226);深圳市医学重点学科(2020-2024年)资助项目(SZXK039)。

摘　　要：目的通过采用总嘶哑度-粗糙声-气息声-无力声-紧张声(GRBAS)评估高频超声研究甲状软骨钙化与嗓音医学相关性,为喉部病理学、嗓音治疗等医学研究提供超声影像学依据。方法选择2018年11月至2019年11月在深圳市龙岗区耳鼻咽喉医院经高频超声检查发现的100例甲状软骨钙化患者,其中男性74,女性26例;年龄19~48岁,中位年龄37.2岁。依据声像图特征,将甲状软骨钙化超声图像分型。再采用日本音声言语医学会制定的GRBAS进行评估。分析甲状软骨钙化的高频超声分型与GRBAS评估之间的相关性。结果100例患者中,Ⅰ型甲状软骨钙化31例,Ⅱ型甲状软骨钙化29例,Ⅲ型甲状软骨钙化23例,Ⅳ型甲状软骨钙化17例。甲状软骨钙化的高频超声分型与GRBAS评估的总嘶哑度、粗糙声、紧张声呈正相关(Spearman=0.154、0.920、0.209,P<0.05),甲状软骨钙化的高频超声分型与GRBAS评估无力声呈负相关(Spearman=-0.328,P<0.05)。甲状软骨钙化的高频超声分型与GRBAS评估气息声强相关,差异无统计学意义(Spearman=0.831,P>0.05)。结论嗓音医学与甲状软骨钙化超声分型联系密切,高频超声可作为临床检查甲状软骨钙化的一种有效方法。Objective To evaluate medical relevance of thyroid cartilage calcification by high-frequency ultrasound and using total grade-roughness-breathiness-asthenia-strain(GRBAS)in phoniatrics,and provide ultrasound imaging basis for laryngo pathology and voice therapy.Methods From November 2018 to November 2019,a total of 100 patients with thyroid cartilage calcification examined by high-frequency ultrasound were enrolled,which included 74 males and 26 females,aged 19-48 years old with median age of 37.2 years old.The ultrasound image of thyroid cartilage calcification was classified according to characteristics of sonogram.The GRBAS of Japanese Society of Phonological and Speech Medicine were used for evaluation.The correlation between high-frequency ultrasound classification of thyroid cartilage calcification and GRBAS assessment was analyzed.Results Of the 100 patients,31 were typeⅠthyroid cartilage calcification,29 of typeⅡthyroid cartilage calcification,23 of typeⅢthyroid cartilage calcification and 17 of typeⅣthyroid cartilage calcification.The high-frequency ultrasound classification of thyroid cartilage calcification was positively correlated with total hoarseness,roughness,and tension of the GRBAS assessment(Spearman=0.154,0.920,0.209,P<0.05),the high-frequency ultrasound classification of thyroid cartilage calcification was negatively correlated with weakness sound of GRBAS assessment(Spearman=-0.328,P<0.05).There was no significant difference between high-frequency ultrasound classification of thyroid cartilage calcification and breath sound of GRBAS assessment(Spearman=0.831,P>0.05).Conclusion It is demonstrated that phoniatrics medicine is closely related to ultrasound classification of thyroid cartilage,and high-frequency ultrasound can be used as the effective method for clinical examination of thyroid cartilage calcification.

关 键 词：甲状软骨 钙化 总嘶哑度-粗糙声-气息声-无力声-紧张声(GRBAS) 嗓音医学 嗓音 解剖结构 高频超声 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R767.3[医药卫生—诊断学]