多层螺旋CT三维后处理技术对茎突的观测及茎突过长综合征的诊断价值

目的：利用多层螺旋CT（ MSCT）三维后处理技术对正常人群茎突形态、长度、方位角进行观察，与临床确诊茎突综合征（ SPS）的患者的茎突进行对比，探讨形态长度、方位角及茎突形态对SPS诊断的价值。方法使用64排螺旋CT的容积再现（ VR）和多层面重建（ MPR）技术对146例292侧非SPS人群茎突和46例66侧临床确诊为SPS的茎突进行评估及测量，评估茎突的形态、测量茎突的长度及方位角。结果将对照组分为＜20岁，20～40岁及≥40岁3组，各组茎突长度平均值为（21．27±17．44）mm，（32．00±8．52）mm，（30．33±7．77）mm，＜20岁组茎突长度小于另外两组，差异有统计学意义（ P＜0．05），≥40岁组内倾角为（71．27±4．55）°，前倾角为（68．49±4．66）°。 SPS组茎突度长度（36．26±8．47）mm，内倾角为（68．12±3．65）°，前倾角为70．05±5．04度，SPS组茎突长度、内倾角与≥40岁对照组茎突长度、内倾角差异均有统计学意义（P＜0．05），SPS组茎突长于≥40岁对照组，内倾角小于≥40岁对照组，而两组间前倾角差异无统计学意义（P＝0．059，P＞0．05）。对照组三个年龄段茎突形态差异有统计学意义（两两对比P＜0．05），随年龄增长完整型所占比例增大，≥40岁对照组与SPS组对比茎突形态差异无统计学意义（ P＝0．133，P＞0．05）。结论 MSCT是目前观测活体茎突的最准确方法，测量茎突时应使用MPR进行测量，对于茎突形态的观察应结合VR和MPR。随年龄增长茎突有逐渐骨化及增长趋势。茎突过长、内倾角过小是诊断SPS的重要依据，而茎突骨化程度的增加也是SPS的发病因素之一。

Multi-slice spiral CT evaluation of the styloid process and diagnosis of styloid process syndrome

Objective To measure styloid shape, length and azimuth of healthy individuals by three-dimension-al post-hoc processing technology of the multi-slice spiral CT (MSCT), and evaluate its value in diagnosis of styloid process syndrome ( SPS) .Methods Volume reproduction ( VR) and multi-planar reconstruction ( MPR) technology of 64-slice spiral CT were used to evaluate styloid process of 146 healthy individuals and 46 SPS patients for morphology, length and azimuth.Results The control group was divided into three groups by ages,<20 years old, 20 to 40 years old and above 40 years old.Average length of styloid process in the three groups was (21.27 ±17.44) mm, (32.00 ±8.52) mm and (30.33 ±7.77)mm, respectively.Length in the <20 years old group was less than in the other groups (P<0.05).The average inward deflection angle in the above 40 years old group was (71.27 ±4.55) degrees and the average forward angle was (68.49 ±4.66) degree.The average length of styloid in the SPS group was (36.26 ±8.47) mm,the average inward deflection angle (68.12 ±3.65) degrees, and the average forward deflection angle (70.05 ±5.04) de-grees.The length of styloid process in the SPS group was longer than in the control group of above 40 years old and the in-ward deflection angle was less (P<0.05.Forward angle in the two groups were similar (P=0.059).The morphology of styloid process in the three age groups had statistically significant differences ( within-group P<0.05 ) .With growing age, cases of complete type increased.Morphology of styloid process in the control group above 40 ages old and SPS group were similar (=0.133) .Conclusions MSCT is currently the most accurate method to observe and measure the styloid process.It should be measured with MPR technology.In observation of styloid process morphology, VR and MPR should be combined.There is an increasing trend of hyperplasia and ossification of styloid process with growing ages.Elongated styloid process and smaller inward deflection angle are important bases for the diagnosis of SPS.And the increased of ossi-fication is another pathogenic factor for SPS.