阻塞性睡眠呼吸暂停低通气综合征患者的多层螺旋CT表现

The multislice spiral CT scan of the upper airwayin patients with obstructive sleep apnea syndrome

摘要:

目的 探讨阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome, OSAHS）患者上呼吸道多层螺旋CT表现，为手术针对性治疗提供可靠依据。方法 对经多导睡眠监测仪诊断为OSAHS的59例患者行多层螺旋CT扫描，测量上呼吸道横截面积及矢状径、冠状径，比较其与87例正常成人上呼吸道横截面积及各径线的差别。结果 59例OSAHS患者中上呼吸道横截面积有狭窄的计53例，共计85个平面存在狭窄。另有6例无法明确判断具体解剖层面狭窄。53例狭窄中34例患者仅存在1个狭窄平面，其中软腭后区狭窄者23例、悬雍垂区狭窄者4例、舌后区狭窄者3例、会厌后区狭窄者4例；9例患者相邻的两个平面共同狭窄，其中为软腭后区+悬雍垂区者4例、悬雍垂区+舌后区者3例、舌后区+会厌后区者2例；7例患者软腭后区、悬雍垂区和舌后区3个平面同时狭窄。3例患者整个上呼吸道4个解剖层面狭窄。结论 大部分OSAHS患者上呼吸道存在解剖性狭窄，其中最为常见的狭窄部位是软腭后区。多层螺旋CT能够精确测量上呼吸道各层面，并对狭窄部位和范围进行定位，为手术方式的选择提供客观依据。 

Abstract:

Objective To investigate the performance of multislice spiral CT (MSCT) scan of upper respiratory airways in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), providing a reliable basis for specific surgical therapy. Methods 59 patients with OSAHS diagnosed with polysomnography (PSG) were included. The areas and the dimensions of each planes were evaluated and compared to those of 87 normal adults. Results Of all the 59 cases with OSAHS, no specific upper airway stricture sites could be confirmed in 6 and there were one or more upper airway stricture sites summing to 75 in the other 53 patients.34 patients just had only one stricture site, 9 patients had 2 contiguous stricture sites, 7 had 3 stricture sites, and 3 had 4 stricture sites. Conclusion Most patients with OSAHS had anatomic upper airway strictures and soft palate was the most common site. MSCT scan can localize the stricture site accurately, which may provide reliable evidence for treatment scheme and surgical mode.