应用X线头颅定位片测量儿童腺样体

目的:探讨侧位X线头颅定位片在儿童腺样体测量中的应用价值。方法:利用X线曲面体层全景机对45例临床考虑腺样体增生的3～13岁儿童行侧位X线头颅定位摄片,其中40例同时用普通X线机摄常规鼻咽侧位片;然后对X线片进行质量评价和腺样体的测量。对X线片质量采用χ2检验进行统计学分析。结果:侧位X线头颅定位片的摆位简单、准确,可重复性强,对鼻咽部各类结构显示良好。以骨性标志蝶骨翼板根部和枕骨斜坡颅外面连接点,结合下颌骨下缘和蝶鞍垂体窝,作为摄片质量评价的参照。以蝶骨翼板根部和枕骨斜坡颅外面连接点显示清晰,下颌骨下缘和蝶鞍垂体窝边缘锐利、清晰,同时要求腺样体等软组织结构显示清晰为合格片标准。45例侧位X线头颅定位片,完全标准34例,达标率76%。40例常规鼻咽侧位片,完全标准21例,达标率53%。侧位X线头颅定位摄片的质量显著高于常规鼻咽侧位片(P<0.05)。结论:相对于常规鼻咽侧位片,侧位X线头颅定位片具有可操作性强、成像质量高的优势,便于对属于软组织结构的腺样体进行测量,是儿童OSAHS首选的影像学检查方法。

Application of X ray cephalogram in the measurement of adenoids in children

PURPOSE: To evaluate the clinical value of X ray lateral cephalogram in the measurement of adenoids in children. METHODS: 45 cases (aged from 3 to 13 year old) with adenoid hypertrophy suspected clinically were examined with lateral cephalometric projections, of which 40 cases were examined with lateral nasopharyngeal projections at one time. Then the quality of films were appraisal and the adenoids were measured on the film. Student's X(2) test was used for statistics analysis. RESULTS: X ray lateral cephalogram can distinctly reveal the structure of nasopharynx. The method was simply and reproducible. The quality of the films were determined based on the conjunction between the base of the pterygoid plate and extracranial aspect of the occipital slope, with consideration of the mandibular margin and sphenoid saddle. The conjunction should be clearly demonstrated and the edges of the mandibular margin and sphenoid saddle should be sharp and well demarcated in qualified films. 45 cases were examined with lateral cephalometric projections, 34 cases had standard films, accounting for 76%. 40 cases were examined with lateral nasopharyngeal projections, 21 had standard films, accounting for 53%. The quality of X ray lateral cephalogram was significantly better than lateral nasopharyngeal projections (P<0.05). CONCLUSION: Compared with the routine lateral nasopharyngeal projection, lateral nasopharyngeal cephalogram has images of high quality, is better for showing the nasopharyngeal structures as well as measurement of the adenoids with parenchyma. It is the imaging method of choice for children with OSAHS.