环杓关节脱位的CT影像表现

The Application of Computed Tomography in the Study of Dislocation of Cricoarytenoid Joint

目的总结环杓关节脱位在螺旋CT影像上的表现,探讨CT在环杓关节脱位诊断中的参考作用。方法25例（左侧19例,右侧6倒）经电子喉镜、喉肌电图检查并结合病史诊断为环杓关节脱位患者,在平静呼吸及Valsalva呼吸状态下,分别进行喉部多层螺旋CT扫描,在CT轴位图像上设计两种测量方法,记录测量数据,并与20例健康人比较。结果25例患者轴位CT图像均显示左右环杓关节不对称,声门裂水平形成的三角形两侧底角不相等,角度相差18.80°±9.86°（7°~45°）,13例（左侧9例,右侧4例）患侧底角大于健侧底角;左右声带突水平线均不重合,距离为2.62°±0.76°（1~4）mm,17例（左侧14例,右侧3例）患侧声带突水平线高于健侧。14例前脱位患者的患侧水平线均高于健侧水平线,11例后脱位的患者中,8例患侧水平线低于健侧水平线,正常对照组中15例两侧底角完全相等,5例两侧底角差值为1°~3°;16例左右声带突水平线完全重合,4例差距为0.5~1mm。环杓关节脱位患者的声门裂两侧底角和声带突水平线的差值与正常对照组比较差异均有统计学意义（P〈0.01）。结论喉部轴位CT图像声门裂两侧底角及声带突水平线的比较可以提供诊断环杓关节脱位的有效参数。

Objective To study the application of computed tomography to dislocation of cricoarytenoid joint.The diagnostic role of CT scan was discussed.Methods Twenty-five patients with arytenoid dislocation identified by fiberoptic laryngoscopy and laryngeal electromyography and 20 normal persons were included in this study with spiral CT.Scans were performed under the condition of breath control and Valsalva,respectively.Results The dislocation of cricoarytenoid joints was consistently demonstrated on several of the overlapping thin axial reconstructions in each of 25 patients.The asymmetry of the bilateral cricoarytenoid joints was noted on axial image.The value-difference of two basal angles ranges form 7 to 45,and the distance of two horizontal of vocal processes ranges from 1~4 mm.Significant difference was observed between the study and the control groups（P0.01）.A comparison of left-and right-side arytenoid dislocation was made,but no significant difference was observed between them（P0.05）.However,there was a significant difference between the anterior team and posterior team（P0.01）.Conclusion The findings that two-side basal angle are not equal in triangle and the two horizontal is not coincidence of glottic fissure can be used as two parameters to arytenoid dislocation.