成人会厌和声门上结构急性炎症的放射学表现再评估

A reappraisal of the radiologic findings of acute inflammation of the epiglottis and supraglottic structures in adults.

作者信息

Nemzek W R, Katzberg R W, Van Slyke M A, Bickley L S

机构信息

Department of Diagnostic Radiology, University of California Davis Medical Center, Sacramento 95817, USA.

出版信息

AJNR Am J Neuroradiol. 1995 Mar;16(3):495-502.

PMID:7793372

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8337648/

Abstract

PURPOSE

To evaluate the radiologic characteristic of acute inflammation of the epiglottis and supraglottic structures in adults.

METHODS

The clinical and radiographic findings in 27 adult patients with epiglottitis (average age, 43 years; range, 28 to 81 years) were compared with those of a control group of asymptomatic subjects (n = 15; average age, 48 years; range, 24 to 79 years). Unusual clinical aspects in the current series included two patients who were positive for human immunodeficiency virus, 1 with acquired immunodeficiency syndrome and Kaposi sarcoma, 3 with emphysematous epiglottitis, 1 with abscess formation, and 1 with laryngeal carcinoma. One patient required emergency tracheostomy. One patient died of pneumonia.

RESULTS

The ratio of the soft-tissue parameters to the anteroposterior width of the C-4 vertebral body yielded three key parameters of high statistical significance in adult epiglottitis. The ratio of the width of the epiglottis to the anteroposterior width of C-4 should not be greater than 0.33 (sensitivity, 96%; specificity, 100%). The ratio of the prevertebral soft tissue to C-4 should not exceed 0.5 (sensitivity, 37%; specificity, 100%) and the ratio of the width of the hypopharyngeal airway to the width of C-4 should be less than 1.5 (sensitivity, 44%; specificity, 87%). The aryepiglottic folds were enlarged in 85%, and the arytenoids were swollen in 70% of the patient population (specificity, 100%).

CONCLUSION

These defined radiologic parameters should aid in the diagnosis of acute epiglottitis in adults.

摘要

目的

评估成人会厌和声门上结构急性炎症的放射学特征。

方法

将27例成人会厌炎患者（平均年龄43岁；范围28至81岁）的临床和影像学表现与15例无症状对照受试者（平均年龄48岁；范围24至79岁）进行比较。本系列中不寻常的临床情况包括2例人类免疫缺陷病毒阳性患者，1例患有获得性免疫缺陷综合征和卡波西肉瘤，3例患有气肿性会厌炎，1例有脓肿形成，1例有喉癌。1例患者需要紧急气管切开术。1例患者死于肺炎。

结果

在成人会厌炎中，软组织参数与C-4椎体前后径的比值产生了三个具有高度统计学意义的关键参数。会厌宽度与C-4椎体前后径的比值不应大于0.33（敏感性96%；特异性100%）。椎前软组织与C-4的比值不应超过0.5（敏感性37%；特异性100%），下咽气道宽度与C-4宽度的比值应小于1.5（敏感性44%；特异性87%）。85%的患者杓会厌襞增宽，70%的患者杓状软骨肿胀（特异性100%）。