多层螺旋CT在阻塞性睡眠呼吸暂停低通气综合征中的应用价值

The Application Value of Multi-slices Spiral CT in Obstructive Sleep Apnea Hypopnea Syndrome

目的采用多层螺旋CT行上气道动态扫描,结合多平面重组后处理技术测量观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者上气道咽腔大小形态改变特点,分析判断阻塞位点,探讨其在指导临床诊治中的应用价值。资料与方法对24例OSAHS患者及12名健康志愿者分别在平静呼吸、深吸气末、深呼气末及闭口堵鼻(M櫣ller)吸气状态下进行上气道CT连续扫描,测量不同时相下各咽部截面积,判断阻塞位点并与临床指标进行相关性分析。结果OSAHS患者咽部气道面积小于对照组,其中尤以腭后区及舌后区截面积减小程度显著;病情程度不同患者腭后区面积在平静呼吸和吸气末状态下存在显著差异;腭后区平静呼吸和吸气末时的截面积与呼吸紊乱指数(AHI)呈负相关,舌后区吸气末截面积与颈围呈负相关。结论运用多层螺旋CT进行上气道动态扫描并辅以形态测量可有效判断OSAHS患者上气道咽腔狭窄情况,对指导临床诊断和治疗该疾病具有参考价值。

Objective To discuss the characteristics of UA shape change and the obstructed sites using multi-slices spiral computed tomography （MSCT） with multi-planar reconstruction technique （MPR）, and estimate the value of MSCT in the diagnosis and treatment of OSAHS. Materials and Methods The 24 patients with OSAHS and 12 controls were scanned by MSCT in the phases of quiet stable respiration, deep inspiration, deep expiration, and Müller action. The cross-section areas at different pharynx levels were measured respectively under the four respiratory states. The sites of narrow in UA were studied. Correlation analysis Was carried out between the MSCT and clinical data. Results The pharynx cavities in OSAHS were smaller than those of the controls, especial at the soft palate and tongue levels. The cross-sections ＂areas at the soft palate level under the quiet stable respiration and deep inspiration states had significant statistical difference aniong different severity of OSAHS and had negative correlation with AHI. There was also negative correlation between the naso-pharyngcal cross-section area and the neck circumference in the phase of inspiration. Conclusion Dynamic scanning and measurement of UA with MSCT can observe the change of pharynx cavity effectively, and have reference value in guiding the clinical diagnosis and treatment.