成人鼻腔气道的多层螺旋CT表现

Study of adult nasal airway by multi-slice spiral CT

目的探讨成人鼻腔气道截面面积-距离曲线的特征及价值。方法根据60名健康志愿者的CT影像数据，在ADW4．1工作站行鼻腔冠状截面重组，测量气道截面面积大小及截面至前鼻孔中心的距离，建立气道截面面积．距离曲线。用独立样本t检验对不同性别间主要解剖位置的鼻腔气道截面积以及鼻孔中心至鼻腔气道截面的距离进行比较。结果120侧鼻腔截面面积一距离曲线形态大致有3型：Ⅰ型56侧（46．7％），Ⅱ型40侧（33．3％），Ⅲ型24侧（20．O％）。鼻瓣区曲线形态：平坦型86侧（71．7％），凹陷型34侧（28．3％）。下鼻甲前端区曲线表现为浅切迹型48侧（40．0％），深切迹型54侧（45．0％），无切迹型18侧（15．0％）。中鼻甲前端区曲线表现为浅切迹型31侧（25．8％），深切迹型38侧（31．7％），无切迹型51侧（42．5％）。鼻腔最小横截面积位置，76侧（63．3％）位于鼻瓣，26侧（21．7％）位于下鼻甲前端，15侧（12．5％）位于鼻瓣前方，1侧位于中鼻甲前端，2侧位于后鼻孔前方第1个狭窄处。双侧曲线吻合好38名（63．3％），吻合差22名（36．7％）。男性和女性鼻瓣处鼻腔气道截面积分别为（197．9±41．2）和（151．2±35．5）mm^2，后鼻孔鼻腔气道截面积分别为（361．8±97．9）和（296．3±81．8）mm^2，差异均有统计学意义（t值分别为4．707和0．007，P〈0．01）。男性和女性鼻孔至鼻瓣层面距离分别为（14．0±2．4）和（11．8±2．9）mm，差异有统计学意义（t=3．232，P〈0．01）。结论CT鼻腔气道曲线因个体而异，CT可为鼻腔通气功能评估提供个体化信息。

Objective To investigate the characteristics and value of nasal area-distance curves. Methods Based on data from CT images, nasal cavity cross-sectional areas in 60 volunteers were reconstructed. The size of each nasal airway and the distance from nostril to the corresponding cross-sectional area were measured. Area-distance curves were then established according to data obtained, t test was used to analysis the data. Results Three types of curves were found and categorized according to their shapes. Type Ⅰ consisted of 56 sides （46. 7% ） ,type Ⅱ 40 sides（33.3% ）, and type Ⅲ 24 sides （20. 0% ）. For curves of nasal valve area, smooth type was seen in 86 sides （71.7%）, and concave type in 34 sides （28. 3% ）. Curves in area of inferior turbinate head were seen with shallow notch（48 sides,d0. 0% ）, deep notch （54 sides,45.0% ）, and no notch（ 18 sides,15. 0% ）. Curves in area of middle turbinate head were seen with shallow notch （ 31 sides, 25.8% ）, deep notch （ 38 sides, 31.7% ）, and no notch （ 51 sides, 42.5% ）. Nasal minimal cross-sectional area was located at nasal valve area in 76 sides （63.3%） , head of inferior turbinate in 26 sides （ 21.7% ） , region anterior to nasal valve in 15 sides （ 12. 5% ） , head of middle turbinate in 1 side, and region anterior to choana in 2 sides. The cross-sectional area at nasal valve in men and women were （197. 9±41.2） and （151.2±35.5） mm^2, respectively. The cross-sectional area at choana in men and women were （ 361.8 ± 97. 9 ） and （ 296. 3 ± 81.8 ）mm^2, respectively. There was significant difference between men and women at both sites （ t = 4. 707 and 0. 007, P 〈 0. 01 ）. The distance from nostril to nasal valve in men and women were （ 14.0 ± 2.4） and （ 11.8 ± 2. 9） mm, which presented significant difference, too （t = 3. 232 ,P 〈 0. 01 ）. Conclusions CT nasal area-distance curve varied with individual, CT may provide information for evaluating nasal passage on individual basis.