以多層螺旋電腦斷層之多層面數位重建研究正常呼吸狀態下的聲帶

Multi-slice Spiral Computed Tomography with Multi-planar Reformatting of the Vocal Folds during Normal Tidal Respiration

陳建志(Jiann-Jy Chen) ； 沈里國(Li-Kuo Shen) ； 王興萬(Hsing-Won Wang) ； 陳登郎(Dem-Lion Chen)

《台灣耳鼻喉頭頸外科雜誌》 47卷4期 (2012/12) Pp. 262-270

https://doi.org/10.6286/2012.47.4.262

摘要

背景：2維多層面數位重建是一種運用於電腦斷層之影像後處理技術，本文首度運用該法研究正常成年人在一般呼吸狀態下的聲帶，期待未來能對聲帶解剖及生理研究頗多啟發。方法：共有220名（男122，女98）成年以上之患者（≧18歲）納入本研究，年齡45.7 ± 19.1歲（平均值±標準差），均曾於本院急診接受頸椎電腦斷層檢查，但診斷為陰性。把儲存的立體像素輸出到後置影像處理系統，開啟2維多層面數位重建功能，設法找到恰位於兩側杓骨尖端與前聯合後端的聲門平面，測量前聯合厚度、兩側膜性聲帶平均直線長度及夾角，以及聲門氣道面積。統計分析採用雙尾t檢定，α值設為.05。結果：男性前聯合厚度（3.08 ± 1.59 mm）大於女性（2.50 ± 1.37 mm）（p = .004）。男性兩側膜性聲帶平均直線長度（15.39 ± 2.46 mm）大於女性（12.13 ± 2.33 mm）（p = 3.79 × 10^(-20)）。女性兩側膜性聲帶直線夾角（42.90 ± 10.97°）大於男性（38.89 ± 10.13°）（p = .006）。男性聲門氣道面積（165.79 ± 48.87 mm^2）大於女性（107.02 ± 35.18 mm^2）（p = 1.61 × 10^(-20)）。結論：本文首次確認在一般呼吸狀態下，正常成年男女聲門之前聯合厚度、兩側膜性聲帶及聲門氣道面積是不同的，而且年齡進展確實會影響到聲帶。

關鍵字

多層螺旋電腦斷層 ； 多層面重建 ； 聲帶 ； 前聯合 ； 聲門氣道

並列摘要

BACKGROUND: 2D Multi-planar reformatting (2D MPR) is a post-processing technique that is able to create new images from a stack of images in planes other than that of the original stack. We describe here the first use of this method to study normal adult vocal folds during tidal respiration. It is expected that this study will help the study of glottic anatomy and physiology.METHODS: METHODS: A total of 220 adult patients (≥ 18 years old) (122 men and 98 women) aged 45.7 ± 19.1 (average ± SD) were enrolled. These individuals had received cervical spinal computed tomography, but had no disease diagnosed. The image datasets were then transferred to a post-processing computer workstation that allows the generation of 2D MPR. We tried to generate an axial cut at the vocal points of the bilateral arytenoid cartilages and the posterior end of anterior commissure. The thickness of anterior commissure, the straight lengths of the bilateral membranous vocal folds, the included angle of the bilateral membranous vocal folds and glottic airway area were measured. The results were statistically analyzed using two-tail t-tests (α =0.05).RESULTS: The thickness of anterior commissure was greater in men (3.08 ± 1.59 mm) than in women (2.50 ± 1.37 mm) (p = 0.004). The average straight length of bilateral membranous vocal folds was also greater in men (15.39 ± 2.46 mm) than in women (12.13 ± 2.33 mm) (p = 3.79 × 10^(-20)), but the included angle of the bilateral membranous vocal folds was greater in women (42.90 ± 10.97°) than in men (38.89 ± 10.13°) (p = 0.006). The glottic airway area was larger in men (165.79 ± 48.87 mm^2) than in women (107.02 ± 35.18 mm^2) (p = 1.61 × 10^(-20)).CONCLUSIONS: We performed a preliminary study to confirm that the anatomy of the anterior commissure, bilateral membranous vocal folds and glottic airway are different between normal adult men and women during tidal respiration. In addition, age progression may also influence the anatomy of normal adult vocal folds.

並列關鍵字

multi-slice spiral CT ； multi-planar reformatting ； vocal fold ； anterior commissure ； glottic airway