Müller状态下128排螺旋CT三维重建在OSAS患者上气道阻塞平面评估中的价值

doi:10.6040/j.issn.1673-3770.0.2018.368

摘要/Abstract

摘要： 目的探讨Müller状态下128排螺旋CT上气道薄层扫描及三维重建技术在评估阻塞性睡眠呼吸暂停综合征(OSAS)患者上气道阻塞平面中的价值。方法选取42例成人中重度OSAS患者,分别于平静呼吸和Müller状态(模拟睡眠憋气状态)下行128排螺旋CT薄层轴位扫描并行上气道三维重建,测量并比较两种状态下相同上气道平面各横截面积、各径线长度、软腭悬雍垂长度及厚度、舌骨至硬腭距离等参数。结果与平静呼吸状态相比,Müller状态下除会厌后区前后径的差异无统计学意义(t=1.837, P =0.073),其余各阻塞平面的前后径、左右径等径线测量值及横截面积的差异有统计学意义(腭后区左右径、前后径、横截面积的t分别为6.214、6.969、8.192, P均<0.001;舌后区左右径、前后径、横截面积的t分别为6.170、2.510、8.579, P分别<0.001、0.016、<0.001;会厌后区左右径、横截面积的t分别为4.279、6.104, P均<0.001);软腭厚度、软腭及悬雍垂长度差异均有统计学意义(t分别为-4.473、5.724, P均<0.001);舌骨的位置下移,差异有统计学意义(t=-6.302, P<0.001)。结论 Müller状态下128排螺旋CT上气道薄层扫描及三维重建技术可评估OSAS患者上气道阻塞平面和各平面软组织的顺应性,有助于阻塞平面的分类,为OSAS患者个体化治疗方案的选择提供参考。

关键词: 睡眠呼吸暂停综合征, 上气道, 计算机体层摄影, 三维

Abstract: Objective To explore the value of airway thin-layer scanning and three-dimensional reconstruction in 128-slice computed tomography(CT)in the assessment of upper airway obstruction in patients with obstructive sleep apnea syndrome(OSAS)in the Müller state. Methods Forty-two adult patients with moderate or severe OSAS in the state of quiet breathing and Müller maneuver(analog sleep breathing state)underwent 128-slice thin axial CT. CT software was used for the three-dimensional reconstruction of the upper airway, and the two states were examined and compared under the same planes of the cross-sectional area of retropalatal region. The warp length, length and thickness of the soft palate uvula, vertical length from the hard palate to the upper posterior part of the hyoid, and other parameters were evaluated. Results Compared with the quiet breathing state, except for the area under the Müller state, diameter differences before and after the area after the epiglottis were statistically significant(t=1.837, P=0.073). The rest of the plane blocked the left and right anteroposterior diameter based on the equal line measurement and cross-section. There were significant differences in the area(t=6.214, 6.969, 8.192, respectively; all P<0.001). The left and right areas of the tongue, front and rear diameters, and cross-sectional area t were 6.170, 2.510, and 8.579, respectively, and P was<0.001, 0.016, and<0.001, respectively. The left and right areas of the epiglottis area and transverse area t were 4.279 and 6.104, respectively, and all P values were <0.001. The differences in soft palate thickness and soft palate and uvula length were statistically significant(t=-4.473 and 5.724, respectively; all P<0.001). The position of the hyoid bone moved downward, and the difference was statistically significant(t=-6.302, P<0.001). Conclusion The three-dimensional reconstruction of the upper airway on 128-slice CT can better assess patients with OSAS in the airway obstruction plane, in favor of blocking the classification plane, and the value of predicting the outcome of estimated UPPP surgery can be estimated, providing references to patients with OSAS for individualized treatment.

Key words: Sleep apnea syndrome, Upper airway, Computed tomography, Three-dimensional

中图分类号:

R714.253

张丙文,陈荣荣,吴元庆,徐进敬,姜亮,戚建伟. Müller状态下128排螺旋CT三维重建在OSAS患者上气道阻塞平面评估中的价值[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 90-94.

ZHANG Bingwen, CHEN Rongrong, WU Yuanqing, XU Jinjing, JIANG Liang, QI Jianwei. Value of 128-slice CT 3D reconstruction in the Müller state in the evaluation of the upper airway obstruction plane in patients with OSAS[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(2): 90-94.

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