阻塞性睡眠呼吸暂停综合征患者上气道的锥形束CT和螺旋CT三维测量的临床研究

A clinical study of the three-dimensional measurement of the upper airway by using cone-beam CT and spiral CT in patients with obstructive sleep apnea syndrome

目的:研究螺旋CT(MSCT)和锥形束CT(CBCT)对同一患者上气道相同部位的体积和横截面积的测量结果是否有差异,并且进行两种CT的可靠性分析。方法:将20例阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAHS)患者的MSCT和CBCT分别导入mimics17.0软件中进行上气道体积和横截面积的测量;同一测试者分别进行3次测量。采用SPSS24.0统计软件,进行组内相关系数、配对t检验来检验不同测量方法的可靠性和统计学差异。结果:上气道体积和横截面积测量结果显示二者在鼻咽、舌咽段气道体积的测量值没有统计学差异,而在口咽段气道体积的测量值有统计学差异,并且表面积和横截面积差异均有统计学意义。所有测量项目的ICC值均大于0.75,锥形束CT的ICC平均值为0.933、螺旋CT的ICC平均值为0.921,说明两种测量方法之间无较大差异性。结论:锥形束CT和螺旋CT OSAHS患者上气道的三维测量可靠性和重复性均较高,且两者之间无较大差异。

Objective： To study the difference between the spiral CT（ MSCT） and cone-beam CT（ CBCT） of the same patient in measuring the volume and cross-sectional area of the same part of the upper airway,and to make two CT reliability analysis. Methods： Transforming the spiral CT and cone-beam CT of obstructive sleep apnea syndrome（ OSAHS） patients into the software with highest intra-class correlation coefficient to measure the area and the volume of airway. Each tester was measured for 3 times. The intra-class correlation coefficien were calculated,and the reliability and the statistical significance of different measuring methods were tested by paired t test of variance in order by the utilization of SPSS24. 0 statistical software. Results： There was no statistical difference in nasopharynx and glossopharyngeal airway volume,but there was statistical difference in oropharynx in both surface area and cross-sectional area. ICC values were all greater than 0. 75,and the average ICC value of CBCT was 0. 933,the average ICC value of MSCT was 0. 921,indicating that the reliability of the two measuring methods are relatively high with no great difference. Conclusion： The reliability and repeatability of spiral CT and cone beam CT in OSAHS patients are both high,and there is not much difference between them.