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目的:评价茎突X线平片与螺旋CT三维重建成像(3-DCT)技术在诊断茎突综合征(SPS)的准确性。方法:对113例疑似病例(144侧茎突)记录X线正位平片的茎突长度值并进行咽部指诊,依据茎突X线平片和咽部指诊结果比较临床和影像学检查结果的一致性。对其中23例进行3-DCT检查。记录X线平片和3-DCT两种方法测量同一个体的茎突长度数值,比较两种影像学测量茎突长度的差异和一致性。根据指诊可否触及茎突分组比较茎突前倾角和内倾角的差别。结果:113例中78例被诊断为SPS,茎突X线平片与咽部指诊结果的一致性较好(Kappa指数:0.58)。30侧茎突的X线平片与3-DCT测量茎突长度的差值平均数(1.59±1.32)mm,两法测量茎突长度的差异具有统计学意义(P<0.01),两种影像学检查茎突长度数值之间呈正相关,相关系数为0.982 4,P<0.01。咽部指诊阳性和阴性茎突内倾平均角分别为(25.60±2.56)°和(15.42±2.79)°(P<0.01)。咽部指诊阳性和阴性茎突前倾平均角分别为(16.86±4.83)°和(12.71±3.39)°(P<0.01)。8例咽部指诊单侧阳性的茎突长度正常者,经3-DCT显示茎突角度异常而证实临床诊断。4例术前未满意触及的单侧过长茎突者,经3-DCT显示茎突末端向内向前明显偏斜而采用口内进路手术。结论:茎突X线平片经济、简便、实用,足以为大多数病例的临床诊断提供客观依据。茎突3-DCT可弥补茎突X线平片不足,对部分病例选择手术进路具有重要的参考价值。
Objective: To evaluate the accuracy of styloid X-ray and spiral CT three-dimensional reconstruction imaging (3-DCT) in the diagnosis of styloid process syndrome (SPS). Methods: 113 cases of suspected cases (144 styloid process) record X-ray orthopanal length value of the styloid process and pharyngeal fingerprinting, based on styloid X-ray and pharyngeal fingerprinting results compared clinical and imaging Check the consistency of the results. Twenty-three of them were examined by 3-DCT. The X-ray and 3-DCT methods were used to measure the length of the styloid process in the same individual. The difference and consistency of styloid length between the two methods were compared. According to the diagnosis of palpable salient styloid group compared the difference between the anterior camber and camber. Results: Of 113 cases, 78 cases were diagnosed as SPS. The consistency between X-ray and pharynx was consistent (Kappa index: 0.58). The mean value of the difference of styloid length measured by 3-DCT was 1.59 ± 1.32 mm between the X-ray of 30 styloid process and the styloid length measured by the two methods (P <0.01) The length of styloid process was positively correlated with the correlation coefficient of 0.982 4, P <0.01. The average angle of pronation of the pharyngeal pharynx was (25.60 ± 2.56) ° and (15.42 ± 2.79) ° (P <0.01), respectively. The mean anterior angles of pharyngeal phalanges were (16.86 ± 4.83) ° and (12.71 ± 3.39) °, respectively (P <0.01). 8 cases of pharyngeal finger unilateral positive side of the normal length of the styloid process, demonstrated by 3-DCT styloid abnormalities and confirm the clinical diagnosis. Four cases of unilateral unilateral protracted protracted tubercles who were not satisfactorily preoperatively were treated with intraoral approach by 3-DCT. Conclusion: X-ray of styloid process is economical, simple and practical, which can provide an objective basis for the clinical diagnosis of most cases. Styloid process 3-DCT can make up for styloid X-ray film is insufficient, in some cases the choice of surgical approach has important reference value.