正常成人上呼吸道CT测量及其意义

目的：确定正常人的上呼吸道CT扫描下各平面的横截面积、经线长度以及咽壁厚度，为临床服务。方法：无明显睡眠呼吸疾病史的成年人（男115、女110），采用Philips Tomoscan AV Expander E1螺旋CT，对鼻咽顶部到声门之间的区域进行连续扫描，测量软腭后区、悬雍垂后区、舌后区和会厌后区的气道横截面积、失状径、冠状径、咽侧壁和咽后壁软组织厚度，以单侧95％可信区间确定各测量指标的参考值。结果：在上呼吸道各个扫描平面，绝大多数气道的形状均为横椭圆形，冠状径大于失状径，在软腭后区、悬雍垂后区、舌后区和会厌后区中，失状径大于冠状径者分别占总人数的3．11％、10．67％、0．8％和0％。各年龄组间比较，绝大多数测量指标差异不显著，男子组和女子组间比较，除软腭后区外，大多数测量指标差异显著。故分别制定了男、女各测量指标的还范围。结论：成人上呼吸道CT测量以及正常范围的确定为临床判定OSAS患者上呼吸道解剖性狭窄的部位提供了客观依据，男性OSAS发病率明显高于女性有其相关的生理基础。

The CT assessment of normal adult upper airway

Objective: To measure the dimension of North Chinese upper airway on CT scan and to establish the diagnosis criterion of upper airway stricture. Methods: This study involved 225 normal adults without any apnea or snoring symptoms. The upper airways from roof of nasopharynx to glottis were evaluated by using Phlips Tomoscan AV Expander E1 spiral CT scanner. The areas and the dimensions of palate, uvula, lingua and epiglottis region were studied, and the thicknesses of retropharyngeal and lateral pharyngeal tissue were evaluated also. The normal extent of every variable was determined by unilateral 95% confidence interval. Results: The shapes of most upper airway across the section at different levels were transverse ellipse and the coronary diameter was larger than arrowy dimension. The ratio of testee who show longitudinal across section of upper airway at palate, uvula, lingua and epiglottis region were 3.11 %,10.67%,0.8% and 0% respectively. There was not obviously difference in most of variables among different age group. Besides of palate region,there was significant difference in most of variables between male and female. The normal extents of upper airway variables were established in male and female respectively. Conclusions:The CT assessment of normal adult upper airway can give an objective criterion to the diagnosis of upper airway stricture and the location of stricture site in OSAS patients. There are intrinsic anatomic factors which bring about more OSAS patients in male.