喉组织切片与喉CT图像的对照研究及三维重建

目的对喉部MSCT和组织切片图像及其三维重建的比较研究。方法 30例(21男,9女)结构完整的喉标本,全喉连续大切片,HE染色,专业微距照相系统拍照,专业图像分析;30名(12男,18女)健康志愿者经64排高分辨率薄层MSCT扫描,得到喉部CT图像。在用3D-Doctor软件进行MSCT三维重建。测量组织切片和MSCT三维重建喉甲状软骨、环状软骨和6个切面会厌前间隙和声门旁间隙的面积,进行两组独立样本的t检验。结果 MSCT图像中甲状软骨、会厌软骨和环状软骨能清晰显示,但杓状软骨显示不全。会厌前间隙和声门旁间隙内容结构无法显示,而组织切片清晰显示间隙内容。组织切片和MSCT甲状软骨、环状软骨的测量结果无显著性差异(P0.05)。除了甲状软骨声带附着处至上、下切迹距离等四项数据无性别差异(P0.05)以外,其他数据均有性别差异(P0.05)。MSCT切割平面与组织切片会厌前间隙和声门旁间隙面积的测量结果无显著性差异(P0.05)。结论 MSCT对超过其分辨率的细微结构显示欠佳,其三维重建的细节效果不如组织切片完整清晰。组织切片能对MSCT起到良好的补充作用,使得MSCT及其三维重建作为临床医疗诊断和影像学检查的辅助工具,更适合于临床应用。

Comparative study on serial slices and MSCT of the larynx and laryngeal MSCT three-dimensional reconstruction

Objective　To compare anatomic features between slices and MSCT images of larynx and reconstruct three-dimensional larynx image by MSCT data.　Methods　Thirty normal cadaveric laryngeal specimens (21 male and 9 female) were collected. Serial slices of whole larynx were made, and then stained by hematoxylin and eosin (HE). Images of serial slices were acquired with professional microspur photography system and analyzed with professional image software. 30 normal volunteers (12 male and 18 female) were scanned quickly from head to shoulder by 64-slice multi-slice spiral computer tomography (MSCT) and MSCT images were collected. Three-dimensional reconstruction of MSCT images were accomplished by 3D-Doctor software. Measurements of thyroid and cricoid cartilage and areas of preepiglottic and paraglottic spaces in 6 sections were made. Measured data were compared by two independent sample t-test.　Results　Thyroid, epiglottic and cricoid cartilages on MSCT images showed clearly, however, arytenoid cartilage showed incompletely. Tissue structures in the preepiglittic and paraglottic spaces were not able to display, but slices can do. Comparisons of measured data between serial slices and MSCT were not different (P>0.05). In addition to the distance from the vocal cords attachment to superior notch of thyroid, other data had gender differences (P<0.05). The measuring results of preepiglottic and paraglottic spaces of MSCT and serial slices were not significant (P>0.05).　Conclusions　MSCT is unvaluable for demonstrating fine structures of larynx which exceed its resolution, however, serial slices are beneficial supplement for solving this problem, and which is helpful for clinic application undergo mainly by MSCT.