本文選題：磁共振 + 電影成像��； 參考：《重慶醫(yī)科大學(xué)》2011年碩士論文

【摘要】：背景與目的： 近年來(lái)，隨著睡眠醫(yī)學(xué)的不斷發(fā)展，人們逐漸認(rèn)識(shí)到睡眠障礙是影響兒童生長(zhǎng)發(fā)育的重要因素之一。兒童中最常見(jiàn)且最為嚴(yán)重的睡眠障礙是阻塞性睡眠呼吸暫停低通氣綜合征（Obstructive Sleep ApneaHypoventilation Syndrome）。過(guò)去，對(duì)該綜合征的研究主要采用整夜多導(dǎo)睡眠監(jiān)測(cè)儀、鼻喉咽鏡、X線、CT等檢測(cè)設(shè)備，但均存在一定缺點(diǎn)。近年來(lái)，隨著MR成像技術(shù)的發(fā)展，尤其是MR電影序列的開(kāi)發(fā)應(yīng)用，MRI開(kāi)始被用于上氣道及其相關(guān)疾病的研究，目前，國(guó)內(nèi)有關(guān)MR電影成像評(píng)估睡眠狀態(tài)下正常兒童上氣道的研究尚未見(jiàn)報(bào)道。 本研究利用MR電影成像對(duì)2~7歲正常兒童睡眠狀態(tài)下的上氣道大小及動(dòng)度進(jìn)行測(cè)量和評(píng)估，初步建立國(guó)內(nèi)兒童上氣道MRI測(cè)量的正常值范圍及評(píng)估標(biāo)準(zhǔn)，為進(jìn)一步研究上氣道及其相關(guān)疾病提供理論依據(jù)和參考。 方法： 對(duì)2010.6~2011.2在重慶醫(yī)科大學(xué)附屬兒童醫(yī)院影像科行頭顱MR檢查的2-7歲（中位年齡4歲）兒童進(jìn)行睡眠狀況的問(wèn)卷調(diào)查和臨床篩選，選擇無(wú)任何OSAHS臨床癥狀者112人(男性69人，女性43人)行正中矢狀位及舌中部橫斷位電影MR序列及快速自旋回波反轉(zhuǎn)恢復(fù)序列成像。評(píng)估上氣道通氣狀態(tài)（分為四種狀態(tài)—靜止開(kāi)放、存在一定動(dòng)度、間斷閉合及持續(xù)閉合），測(cè)量上氣道前后徑、動(dòng)度，同時(shí)測(cè)量腺樣體大小，并評(píng)估軟腭的形態(tài)、大小及其信號(hào)強(qiáng)度。 結(jié)果： 1112例中，存在一定程度的氣道動(dòng)度占較高比例，喉咽部存在動(dòng)度50例(44.6%)，鼻咽部存在動(dòng)度44例（39.3%），口咽部存在動(dòng)度8例（7.2%）。喉咽部平均氣道動(dòng)度為2.5mm（范圍0.5mm-7.1mm），鼻咽部腔平均氣道動(dòng)度為2.1mm（范圍0.5mm-4.6mm），口咽部平均氣道動(dòng)度為2.8mm（范圍0.5mm-5.0mm）。 2喉咽部存在一定動(dòng)度的50例中主要表現(xiàn)為舌后綴5例（10%）、喉咽后壁向前運(yùn)動(dòng)26（52%）、舌后綴同時(shí)伴有喉咽后壁向前運(yùn)動(dòng)19（38%）。 3張嘴狀態(tài)下鼻咽部和口咽部運(yùn)動(dòng)出現(xiàn)的比率分別為63.9%（23/36）和19.4%（7/36），顯著高于閉嘴狀態(tài)27.6%(21/76)和1.3%（1/76）；張嘴狀態(tài)下喉咽部運(yùn)動(dòng)出現(xiàn)比率33.3%（12/36），與閉嘴狀態(tài)50.0%（38/76）無(wú)顯著差異。 4腺樣體厚度（10.6±2.1）mm，其中＞12mm者7例（6.3%）。9例（8.0%）軟腭覆蓋并鄰接舌，無(wú)1例軟腭下部向下延伸低于舌中部水平，軟腭呈較均勻稍低信號(hào)（與舌肌肉組織信號(hào)類(lèi)似）。 結(jié)論： 1MRI及MRI電影序列能較準(zhǔn)確地測(cè)量上氣道各段管腔直徑并判斷有無(wú)動(dòng)度，，是一種可用于評(píng)估上氣道及其相關(guān)疾病的理想檢查手段。 2正常兒童睡眠狀態(tài)下可以存在一定程度的氣道動(dòng)度，氣道動(dòng)度一般小于5mm。 3喉咽部動(dòng)度主要表現(xiàn)為舌后綴、喉咽后壁向前運(yùn)動(dòng)及舌后綴同時(shí)伴有喉咽后壁向前運(yùn)動(dòng)三種方式。 4張、閉嘴狀態(tài)對(duì)上氣道的動(dòng)度有一定影響，張嘴狀態(tài)下鼻咽和口咽動(dòng)度出現(xiàn)的比率顯著高于閉嘴狀態(tài)。
[Abstract]:Background and purpose: In recent years, with the continuous development of sleep medicine, people have come to realize that sleep disorder is one of the important factors affecting the growth and development of children. The most common and severe sleep disorder in children is obstructive Sleep ApneaHypoventilation Syndrometic syndrome (OSAS). In the past, the study of this syndrome was mainly carried out by means of overnight polysomnography, nasopharyngeal X ray CT and so on, but all of them had some shortcomings. In recent years, with the development of Mr imaging technology, especially the application of Mr film sequence, MRI has been used in the study of upper airway and its related diseases. There has been no report on the evaluation of upper airway in normal children by Mr film imaging in China. In this study, Mr film imaging was used to measure and evaluate the upper airway size and motility of normal children aged 2 to 7 years, and to establish the normal range and evaluation standard of upper airway MRI measurement in children in China. To provide theoretical basis and reference for further study of upper airway and its related diseases. Methods: The sleep status of children aged 2-7 years (median age 4 years) who underwent cephalic Mr examination in the Department of Imaging of affiliated Children's Hospital of Chongqing Medical University was investigated by questionnaire and clinical screening. 112 patients (69 males) without any clinical symptoms of OSAHS were selected. The median sagittal and middle tongue transection Mr sequences and fast spin echo inversion recovery sequences were performed in 43 women. To evaluate the upper airway ventilation status (divided into four states-static opening, presence of certain motility, intermittent closure and continuous closure, measurement of the anteroposterior diameter and motility of the upper airway, measurement of adenoid size, and evaluation of the shape of the soft palate. Size and signal strength. Results: In 1112 cases, there was a higher proportion of airway motility, 50 laryngopharynx motility, 44 nasopharynx motility, 8 oropharynx motility. The mean airway motility of laryngopharynx was 2.5 mm (range 0.5 mm ~ 7.1 mm), that of nasopharynx was 2.1 mm (range 0.5 mm ~ 4.6 mm), and that of oropharynx was 2.8 mm (range 0.5 mm -5.0 mm). (2) in the 50 cases with certain movement of laryngopharynx, there were 5 cases with tongue suffix, 10 cases with tongue suffix, 2652% with forward movement of larynx wall, and 193838 fold with tongue suffix with forward movement of laryngeal pharynx wall. 3 the ratios of nasopharyngeal and oropharyngeal movements in open mouth were 63.9 / 36) and 19.4 / 36, respectively, which were significantly higher than those in shut up state 27.661 / 21 / 76) and 1.33 / 76 / 76, respectively, but there was no significant difference between 33 / 3 / 36 / 36 of laryngopharynx movement under open mouth and 50.00 / 38 / 76 of shut up state. (4) the thickness of adenoid was 10.6 鹵2.1 mm, of which 7 cases (> 12mm) were covered with soft palate and adjacent to tongue. None of them had a lower soft palate extending down below the level of middle tongue, and the soft palate showed a relatively homogeneous low signal intensity (similar to the signal intensity of tongue muscle tissue). Conclusion: 1MRI and MRI film sequences can accurately measure the lumen diameter of upper airway and judge whether there is movement. It is an ideal method for the evaluation of upper airway and its related diseases. 2A certain degree of airway motility can be found in normal children during sleep, and the airway motility is generally less than 5 mm. 3 the laryngopharynx motility is mainly manifested as tongue suffix, the laryngopharyngeal posterior wall moves forward and the tongue suffix is accompanied by the laryngopharyngeal wall moving forward simultaneously. The ratio of nasopharynx and oropharynx motility in open mouth was significantly higher than that in shut up state.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類(lèi)號(hào)】：R766;R445.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 郭濤;丁寅;;正常骨面型兒童、成人上氣道形態(tài)的X線頭影測(cè)量分析[J];北京口腔醫(yī)學(xué);2006年04期

2 劉月華,曾祥龍,傅民魁,黃席珍;阻塞性睡眠呼吸暫停綜合征患者顱頜面形態(tài)的X線頭影測(cè)量研究[J];北京醫(yī)科大學(xué)學(xué)報(bào);1998年03期

3 張亞梅;兒童阻塞性睡眠呼吸暫停低通氣綜合征的診斷[J];中國(guó)耳鼻咽喉頭頸外科;2005年01期

4 邵劍波;胡道予;夏黎明;王承緣;;兒童腺樣體肥大的MR定量形態(tài)學(xué)研究[J];放射學(xué)實(shí)踐;2006年10期

5 徐建軍;王啟光;陶永君;楊麗芳;;兒童阻塞性睡眠呼吸暫停低通氣綜合征的X線診斷[J];放射學(xué)實(shí)踐;2007年09期

6 魏琳;郭涇;;兒童阻塞性睡眠呼吸暫停低通氣綜合征X線頭影測(cè)量研究[J];廣東牙病防治;2008年05期

7 盧海燕,左艷萍,董福生,馬文盛,陳文靜,吳建瓴;正常兒童上氣道生長(zhǎng)發(fā)育的X線頭影測(cè)量研究[J];河北醫(yī)科大學(xué)學(xué)報(bào);2002年05期

8 魏詠華,蔡中,錢(qián)玉芬;正常兒童上氣道及周?chē)Y(jié)構(gòu)X線頭影測(cè)量研究[J];口腔正畸學(xué);2001年01期

9 孫昌志;鄒華;鄭億慶;葉輝;羅仁忠;;兒童阻塞性睡眠呼吸暫停低通氣綜合征的頭部X線測(cè)量[J];臨床耳鼻咽喉頭頸外科雜志;2007年08期

10 李運(yùn)成;魯際;李麗亞;譚光喜;張曉磷;曾志華;龔捷;宋浩;陳慧;潘均龍;;正常人下頜下腺的多層螺旋CT影像解剖研究[J];臨床放射學(xué)雜志;2007年06期

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