双源CT上气道检查联合多导睡眠监测在阻塞型睡眠呼吸暂停低通气综合征诊断中的应用价值OA
Application of dual-source CT airway examination combined with polysomnography in diagnosis of obstructive sleep apnea syndrome
目的:探讨双源CT上气道检查联合多导睡眠监测(PSG)在阻塞型睡眠呼吸暂停低通气综合征(OSAS)诊断中的应用效果,并分析2种检查的相关性.方法:收集疑诊为OSAS的患者120例,以PSG结果作为金标准,根据呼吸暂停低通气指数(AHI)将患者分为非OSAS组(11例)、轻度OSAS组(35例)、中度OSAS组(43例)和重度OSAS组(31例).根据PSG诊断结果评估双源CT上气道检查对OSAS的诊断效能,比较不同组别患者双源CT上气道检查指标及PSG指标,并行Spearman相关性分析.结果:双源CT检查诊断OSAS的准确率为93.33%(112/120),敏感度为94.50%(103/109),特异度为81.82%(9/11),阳性预测值为98.10%(103/105),阴性预测值为60.00%(9/15),与PSG具有中度一致性(K=0.656).PSG显示,随着OSAS严重程度增加,患者夜间最低血氧饱和度(SpO2)降低,呼吸暂停事件平均时长增加(均P＜0.001).双源CT显示,不同OSAS严重程度患者气道最小横截面积、气道体积、软腭塌陷率、舌根塌陷率差异均有统计学意义(均P＜0.001),病情越严重,气道最小横截面积、气道体积越小,软腭塌陷率、舌根塌陷率越高(均P＜0.001).Spearman相关性分析表明,双源CT上气道最小横截面积、气道体积与AHI及夜间呼吸暂停事件平均时长呈负相关,与夜间最低SpO2呈正相关(均P＜0.001);软腭和舌根的塌陷率与AHI及夜间呼吸暂停事件平均时长呈正相关,与夜间最低SpO2呈负相关(均P＜0.001).结论:双源CT上气道检查联合PSG能更全面地评估患者上气道解剖结构及呼吸功能状态,为OSAS的临床诊断提供更精确的依据.
Objective:To investigate the diagnostic efficacy of dual-source CT airway examination combined with polysomnography(PSG)in obstructive sleep apnea syndrome(OSAS)and analyze the correlation between the two methods.Methods:A retrospective analysis was conducted on 120 patients suspected of OSAS.PSG results were used as the gold standard,and based on apnea-hypopnea index(AHI),120 patients were divided into the non-OSAS group(11 cases),mild OSAS group(35 cases),moderate OSAS group(43 cases),and severe OSAS group(31 cases).The diagnostic efficacy of dual-source CT airway examination for OSAS was analyzed based on PSG results,and the dual-source CT airway examination parameters and PSG parameters were compared among different groups.Spearman correlation analysis was conducted.Results:The diagnostic accuracy of dual-source CT for OSAS was 93.33%(112/120),with a sensitivity of 94.50%(103/109),a specificity of 81.82%(9/11),a positive predictive value of 98.10%(103/105),a negative predictive value of 60.00%(9/15),which was moderately consistent with the PSG results(K=0.656).PSG results showed that as the severity of OSAS increased,the patients'blood oxygen saturation(SpO2)decreased,and apnea duration increased(both P＜0.001).Dual-source CT showed significant differences in minimum airway cross-sectional area,airway volume,soft palate collapse rate and tongue base collapse rate among different OSAS severity levels(all P＜0.001).As the severity increased,the minimum airway cross-sectional area and airway volume decreased,while the soft palate and tongue base collapse rates increased.Spearman correlation analysis revealed that the minimum airway cross-sectional area and airway volume on dual-source CT were negatively correlated with AHI and apnea duration and positively correlated with SpO2(all P＜0.001).The soft palate and tongue base collapse rates were positively correlated with AHI and apnea duration and negatively correlated with SpO2(all P＜0.001).Conclusion:Dual-source CT airway examination combined with PSG can more comprehensively assess the anatomical structure of the upper airway and respiratory function,providing a more precise basis for the clinical diagnosis of OSAS.
李波;程凡芝;姚春慧
喀什地区第二人民医院放射影像中心,新疆 喀什 844000喀什地区维吾尔医医院影像科,新疆 喀什 844000喀什地区第二人民医院放射影像中心,新疆 喀什 844000
医药卫生
阻塞性睡眠呼吸暂停综合征体层摄影术,X线计算机多导睡眠监测上气道检查诊断
Obstructive sleep apnea syndromeTomography,X-ray computedPolysomnographyUpper airway examinationDiagnosis
《中国中西医结合影像学杂志》 2026 (2)
203-206,217,5
喀什地区科技计划项目(KS2021078).
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