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气道解剖结构的三维计算机断层扫描分析

Three-dimensional computed tomographic analysis of airway anatomy.

作者信息

Abramson Zachary R, Susarla Srinivas, Tagoni James R, Kaban Leonard

机构信息

Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA.

出版信息

J Oral Maxillofac Surg. 2010 Feb;68(2):363-71. doi: 10.1016/j.joms.2009.09.086. Epub 2010 Jan 15.

Abstract

PURPOSE

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.

MATERIALS AND METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

材料与方法

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。

结果

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)。

结论

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。

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