Abramson Zachary R, Susarla Srinivas, Tagoni James R, Kaban Leonard
Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA.
J Oral Maxillofac Surg. 2010 Feb;68(2):363-71. doi: 10.1016/j.joms.2009.09.086. Epub 2010 Jan 15.
To test the reliability of a 3-dimensional computed tomographic (3D-CT) analysis of airway size and shape and to correlate the 3D-CT findings with lateral cephalometric measurements.
Fifteen pairs of preoperative maxillofacial 3D-CT scans and digital lateral cephalograms of patients treated for obstructive sleep apnea were used in the present study. Digital 3D-CT reconstructions were created and 12 measurements of airway size and 4 of shape were analyzed. The posterior airway space (PAS), middle airway space, and hyoid to mandibular plane distances were measured on the cephalograms. We then randomly selected 5 CT scans and 5 cephalograms which were analyzed blindly on 5 separate occasions by 2 investigators (Z.A., J.T.) to establish the intraclass correlation coefficients for inter- and intraexaminer reliability. All 15 pairs of images were used to compute the Pearson correlation coefficients to establish the relationship between the CT and cephalometric measurements.
The intra- and interexaminer reliabilities were high for all CT (0.86 to 1.0 and 0.89 to 1.0, respectively; P < .001) and cephalometric measurements (0.84 to 1.0 and 0.91 to 0.99, respectively; P < .001). The CT measurements retroglossal anteroposterior dimension and distance between the genial tubercle and hyoid exhibited a positive correlation with the PAS (r = .60, P = 02 and r = .54, P = .04, respectively), and the lateral/anteroposterior dimension demonstrated an inverse correlation (r = -.68, P = .01) with the PAS.
The results of the present study indicate that the 3D-CT and lateral cephalometric measurements we selected are reliable and reproducible. The only cephalometric measurement that exhibited any correlation with the CT parameters was PAS.
测试气道大小和形状的三维计算机断层扫描（3D-CT）分析的可靠性，并将3D-CT结果与头颅侧位测量结果进行关联。
本研究使用了15对接受阻塞性睡眠呼吸暂停治疗患者的术前颌面3D-CT扫描和数字化头颅侧位片。创建了数字化3D-CT重建图像，并分析了12项气道大小测量值和4项形状测量值。在头颅侧位片上测量后气道间隙（PAS）、中气道间隙以及舌骨至下颌平面的距离。然后随机选择5份CT扫描图像和5份头颅侧位片，由2名研究人员（Z.A.、J.T.）在5个不同场合进行盲法分析，以确定组内相关系数，评估检查者间和检查者内的可靠性。使用所有15对图像计算Pearson相关系数，以确定CT测量值与头颅侧位测量值之间的关系。
所有CT测量值（分别为0.86至1.0和0.89至1.0；P <.001）以及头颅侧位测量值（分别为0.84至1.0和0.91至0.99；P <.001）的检查者内和检查者间可靠性都很高。CT测量的舌后前后径以及颏结节与舌骨之间的距离与PAS呈正相关（分别为r =.60，P =.02和r =.54，P =.04），而外侧/前后径与PAS呈负相关（r = -.68，P =.01）。
本研究结果表明，我们选择的3D-CT和头颅侧位测量方法是可靠且可重复的。与CT参数有任何相关性的唯一头颅侧位测量值是PAS。
