探讨基于MSCT的眶下后筛房的分型初步研究  

Investigation of the types of the infraorbital posterior ethmoid cells based on MSCT images

作　　者：倪婷 邹彩云 储成凤[1] 车子刚[1] NI Ting;ZOU Cai-yun;CHU Cheng-feng(Department of Radiology,Nanjing Tongren Hospital,the Southeast University Medical College,Nanjing 211102,China)

机构地区：[1]东南大学医学院附属南京同仁医院医学影像科,南京211102

出　　处：《放射学实践》2023年第2期167-171,共5页Radiologic Practice

基　　金：南京市医学科技发展计划(QRX17207,YKK20212)。

摘　　要：目的:探讨眶下后筛房(IPEC)的影像解剖学特征,并分析其与慢性鼻窦炎的相关性。方法:回顾性分析2020年12月-2021年2月在本院行副鼻窦CT检查的60例慢性鼻窦炎(CRS)患者及60例健康志愿者(正常对照组)的临床和影像资料。对CT图像进行多平面重组(MPR),观察筛窦和上颌窦的解剖特点,评估IPEC的分型(I型及II型)和位置(左、右侧),采用χ^(2)检验比较CRS组和正常组眶下后筛房出现率的差异。在冠状面图像上测量IPEC的内外径,并在冠状面和矢状面图像上测量上颌窦-筛窦隔的冠、矢状位成角(上颌窦-筛窦隔与纵向垂直线的夹角),采用t检验比较CRS组与正常组之间以及IPECⅠ型与Ⅱ型之间这3项指标值的差异。将有统计学意义的参数纳入logistic回归分析,获得对鉴别IPEC分型及预测鼻窦炎发生有意义的参数。结果:眶下后筛房在CRS组中的出现率为35.0%(21/60),在正常组中为33.3%(20/60),两组之间的差异无统计学意义(χ^(2)=0.037,P>0.05)。在CRS组中,双侧IPEC的出现率为28.3%(17/60),高于单侧6.7%(4/60)的出现率,且差异有统计学意义(χ^(2)=8.048,P<0.05);而在正常组中,单侧和双侧IPEC的出现率分别为13.3%(8/60)和20.0%(12/60),二者之间的差异无统计学意义(χ^(2)=0.800,P>0.05)。CRS组和正常组中分别有IPEC 38和32侧,两组间IPEC的类型及位置分布的差异均无统计学意义(P>0.05)。CRS组和正常组的IPEC内外径分别为(10.16±3.87)和(8.41±3.15)mm,两组之间的差异有统计学意义(t=-2.050,P<0.05);Ⅰ型和Ⅱ型IPEC的内外径分别为(11.86±3.51)和(7.69±2.66)mm,二者之间的差异有统计学意义(t=5.636,P<0.05)。CRS组与正常组之间以及IPECⅠ型与Ⅱ型之间上颌窦-筛窦隔的冠状位和矢状位成角的差异均无统计学意义(P>0.05)。逻辑回归分析结果显示IPEC内外径是预测CRS发生及鉴别IPEC类型的有意义参数(P<0.05)。结论:Ⅰ型眶下后筛房较Ⅱ型更易向外气化,故更可能�Objective:To investigate the radiological characteristics of the infraorbital posterior ethmoid cells(IPEC) and analyze its relationship with chronic rhinosinusitis(CRS).Methods:A total of 120 subjects including 60 CRS patients and 60 normal controls(NC group) from December 2020 to February 2021 were retrospectively included in this study.All subjects underwent paranasal sinus CT scan in our hospital and multi-planner reformation(MPR) images was obtained.The anatomic features of maxillary sinus and ethmoid sinus were observed,the location(left/right) and classification(type Ⅰ and Ⅱ) of IPECs were evaluated,and the frequency of the IPEC between CRS group and NC group were compared by chi-square test.The coronal and sagittal angles of the ethmomaxillary septum(the angles of the ethmomaxillary septum and vertical line on coronal and sagittal images) as well as the medial-lateral diameters of the IPECs were measured,and were compared between CRS group and normal group,and between type Ⅰ and type Ⅱ by t-test.Logistic regression analysis was used to identify the significant variable for classifying IPEC type and for predicting CRS.Results:The presence of IPEC were found in 41 of the 120 subjects,and the frequency was 35.0%(12/60) in CRS group and 33.3%(20/60) in NC group,there was no statistically significant difference between them(χ^(2)=0.037,P>0.05).In the CRS group,the frequency of unilateral and bilateral IPEC was 6.7%(4/60) and 28.3%(17/60) respectively,with statistically significant difference between them(χ^(2)=8.048,P0.05).There were a total of 38 sides in CRS group and of 32 sides in NC group.There was no statistically significant difference in the type and location of the IPECs between the two groups(both P>0.05).The medial-lateral diameters of the IPECs in CRS group and NC group were(10.16±3.87) and(8.41±3.15)mm respectively,and there was statistically significant difference between them(t=-2.050,P0.05).Logistic regression analysis showed that the medial-lateral diameters of IPEC were statistica

关 键 词：慢性鼻窦炎 眶下后筛房 筛上颌窦 上颌窦后上筛房 体层摄影术 X线计算机 

分 类 号：R445.2[医药卫生—影像医学与核医学] R765.4[医药卫生—诊断学]