多层螺旋CT对成人茎突测量与茎突综合征的诊断

The measurement of styloid process in adults by multislice spiral computed tomography and the diagnosis of styloid process syndrome

目的:探讨多层螺旋CT三维表面遮盖法重建(surface shaded display,SSD)及多平面重建(MPR)技术在对成人茎突测量中各种参数和应用价值。方法:分别对20例40侧无咽部、颈部疾病的正常成人及32例40侧临床诊断为茎突综合征(styloid process syndrome,SPS)的患者进行螺旋CT扫描、MPR及三维SSD图像后处理,然后对图像进行测量,测得茎突的长度和内、前偏斜角。结果:40侧正常成人组测得茎突过长(超过30mm)19侧,占47.5%;方位角过大(内或前偏斜角>25°)者2侧,占5%。临床诊断为SPS组40侧测得茎突过长30侧,占75%;方位角过大者17侧,占42.5%。经统计学分析,在SPS组中,茎突过长检出率与方位角过大检出率相比有显著差异(P值为0.003)。方位角过大在SPS组和正常成人组相比检出率明显增多有显著差异(P值为0.000)。结论:多层螺旋CT、MPR及三维SSD图像测量成人茎突非常方便,茎突过长不一定有临床症状,但茎突过长仍是诊断SPS的主要依据,方位角过大是诊断SPS的可靠依据,确诊需结合临床。

Objective： To study the all kinds of parameters and applied value of MSCT 3D, SSD and MPR in the measurement of adult styloid.Methods： MSCT was used in 20 cases （40 sides ）of normal adult and 32 cases （40 sides ） of SPS by clinical, the images were reconstructed into SSD and MPR. Then the length and oblique angle styloid were measured on SSD and MPR. The results were compared with the two groups. Results：In normal adult cases, lengths of styloid was longer than 30mm in 19 sides （47.5%）, the inclination angle of styloid was larger than 25Q in 2 sides （5%）.In SPS cases the elongated styloid was in 30 sides （75%）, the larger inclination angle of styloid was in 17 sides （42.5%）. With statistic retested , the elongated styloid was found more frequently in SPS group than in the larger inclination angle of styloid （ P = 0.003）, the larger inclination angle of styloid was found more frequently in SPS group than in normal adult groups. （ P = 0.0（30）. Conclusion： Mscr are more convincing in measuring the adult styloid. The elongated styloid cases did not often have clinical syndrome. Elongated styloid was the chief provision of SPS, the larger inclination angle of styloid was the very useful provision of SPS. Correct diagnosis of SPS should be based on clinical syndrome.