CAJ | 학술논문

目的：探讨仰卧位DR双能量减影投照方法对阻塞性睡眠呼吸暂停低通气综合征（ obstructive sleep apnea hy－popnea syndrome，OSAHS）辅助诊断价值。方法收集33例经临床及多导睡眠呼吸监测确诊为OSAHS的患者，所有病例均排除小颌畸形；分别行鼻咽部常规DR摄片和DR双能量减影（ DES）摄片，其中DES摄片采用仰卧位。由3位放射诊断医师分别对两组影像学资料中的软腭、悬雍垂及舌根软组织形态，以及导致气道狭窄的情况进行观察和评价，结果采用ROC曲线进行统计分析。结果在检出软腭后区及舌根后区气道狭窄方面，DES组的ROC曲线下面积分别为医师1（0．921／0．974）、医师2（0．950／0．942）、医师3（0．913／0．977），常规 DR组为医师1（0．798／0．716）、医师2（0．771／0．583）、医师3（0．632／0．697），DES组均大于常规DR组，差异有统计学意义（P＜0．05）；在对软腭松弛后坠和舌根后坠的检出率方面，仰卧位DES组也明显高于常规DR组。结论仰卧位DR双能量减影投照法应用于OSAHS的病因诊断，无论在图像清晰度还是诊断准确性上较常规方法均明显提高，有明确的辅助诊断价值。
목적：탐토앙와위DR쌍능량감영투조방법대조새성수면호흡잠정저통기종합정（ obstructive sleep apnea hy－popnea syndrome，OSAHS）보조진단개치。방법수집33례경림상급다도수면호흡감측학진위OSAHS적환자，소유병례균배제소합기형；분별행비인부상규DR섭편화DR쌍능량감영（ DES）섭편，기중DES섭편채용앙와위。유3위방사진단의사분별대량조영상학자료중적연악、현옹수급설근연조직형태，이급도치기도협착적정황진행관찰화평개，결과채용ROC곡선진행통계분석。결과재검출연악후구급설근후구기도협착방면，DES조적ROC곡선하면적분별위의사1（0．921／0．974）、의사2（0．950／0．942）、의사3（0．913／0．977），상규 DR조위의사1（0．798／0．716）、의사2（0．771／0．583）、의사3（0．632／0．697），DES조균대우상규DR조，차이유통계학의의（P＜0．05）；재대연악송이후추화설근후추적검출솔방면，앙와위DES조야명현고우상규DR조。결론앙와위DR쌍능량감영투조법응용우OSAHS적병인진단，무론재도상청석도환시진단준학성상교상규방법균명현제고，유명학적보조진단개치。
Objective To investigate the clinic value of supine DR dual-energy subtraction ( DES) in auxiliary diagnosis of obstructive sleep apnea hypopnea syndrome ( OSAHS) .Methods Thirty-three patients with OSAHS proved by clinic and polysomno-graph underwent the conventional digital radiography (DR) and DES examinations of nasopharyngeal part.Every patient was in supine position for DES.Micrognathism was not pathogenic cause in all patients.The morphological findings of soft palate, uvula and tongue root, as well as airway strictures at corresponding site, were evaluated by three radiologists respectively.The results were statistically analyzed with ROS curve.Results For the detection of airway strictures at retropalatal and retroglottal region level, the area under ROC curve in DES group:Doctor1(0.921/0.974)、Doctor2(0.950/0.942)、Doctor3(0.913/0.977),was larger than that in DR group:Doctor1(0.798/0.716)、Doctor2(0.771/0.583)、Doctor3(0.632/0.697),and there was significant difference between these two groups (P<0.05).As for the detection of soft palate loosening and tongue root retrusion, the area under ROC curve in DES group of patients at supine position was also significantly larger than that in DR group with P<0.05.Conclusions DES technique is obvi-ously superior to conventional DR examination on exploring pathogenic cause of OSAHS, especially for displaying soft palate loosening and tongue root retrusion when DES examinations are performed at supine postures.This technique can eliminate efficiently the influ-ence of bone tissue shadows.It is beneficial to showing pathological changes more clearly, measuring the airway and guiding the clini-cal therapy.