摘要
目的探讨三维磁共振技术观察测量腭咽结构的可行性,并比较腭裂术后成年患者与正常成年人腭咽结构的差异,用于指导腭裂修复术手术方式的选择。方法根据入选标准选择2018年2月至2018年8月就诊于蚌埠医学院第一附属医院整形烧伤科的6例成年男性腭裂修复术后患者(腭裂组),年龄18~26岁,平均21.8岁。招募6例皖北地区健康成年男性(正常组),年龄19~28岁,平均23.3岁。对2组测量对象进行语音检测,评估语音发音和腭咽闭合情况。行正中矢状面静态三维和动态磁共振扫描,在矢状面、冠状面和腭帆提肌平面(斜冠面)测量软腭长、有效软腭长度、腭咽比、腭高、腭帆提肌长度及厚度等32个数据,共测量2次。采用Pearson积矩相关系数对2次数据进行相关性检验,判断测量结果误差大小。使用两独立样本t检验对2组数据进行组间比较。结果所有研究对象均无语音异常,腭咽闭合均完全。2次测量的Pearson积矩相关系数r值范围在0.789~0.925(P<0.05),即2次测量结果误差在可接受范围内。正常组腭帆提肌形态较为流畅,而腭裂组腭帆提肌形态不规则,中线处可观察到不连续现象,且提肌插入软腭时角度明显不同。腭裂组具体测量数据中咽宽为(23.83±3.48)mm、咽深为(29.94±3.52)mm、骨性咽深为(39.68±3.63)mm、腭长比为1.18±0.16、腭咽比为0.87±0.91、发/i:/时软腭膝部和鼻后棘、悬雍垂连线的夹角[PVU角(动)]为(105.68±20.54)°、腭帆提肌内侧段长度为(13.13±1.00)mm、腭帆提肌插入间距为(24.63±2.54)mm、腭帆提肌起点角为(58.0±3.3)mm,均大于正常组,差异具有统计学意义(P<0.05)。腭裂组腭宽为(37.5±1.43)mm、软腭厚度为(9.48±1.03)mm、软腭相对伸长度(/ts/)为(1.09±0.05)mm、安静时鼻后棘和鼻前棘、软腭膝部连线的夹角[APV角(静)]为(180.51±8.55)°、腭帆提肌厚度为(4.07±0.25)mm、腭帆提肌起点间距为(52.27±7.08)mm,均小于正
Objective Using three dimensional magnetic resonance imaging to investigate the differences in velopharyngeal structures and motion between normal resonance adults with repaired cleft palate and without cleft palate,to guide the surgical method of cleft palate repair surgery.Methods Twelve male adults,including 6 adults with repaired cleft palate(cleft group:age 18-26 years old,average 21.8 years old)and 6 adults without cleft palate(noncleft group:age 19-28 years old,average 23.3 years old)were examined with dynamic and static 3D MRI in midsagittal.32 velopharyngeal measures including soft palate length,effective soft palate length,pharynx ratio,palate height,levator veli palatini muscle length and thickness were obtained on midsagittal,coronal,and levator veli palatine image plane(oblique coronal image plane)and compared between groups.The correlation test of two times data were carried out by Pearson product-moment correlation coefficient to determine the error size of the measurement result.Two separate sample t-tests was used to compare the two sets of data.Results All the subjects had no speech abnormalities,and velopharyngeal competence.Two measurements of the r value is 0.789 to 0.925(P<0.05),which is twice the measurement error is within the acceptable range.The noncleft group of levator veli palatini muscle form is more fluid,while the cleft group is irregular,the middle line can be observed discontinuous phenomenon,and the levator veli palatini muscle insertion soft palate angle is obviously different.Compared to those without cleft palate,participants with repaired cleft palate had a significantly bigger pharynx wide(23.83±3.48)mm,pharynx deep(29.94±3.52)mm,bone pharynx deep(39.68±3.63)mm,palate length ratio(1.18±0.16),pharynx ratio(0.87±0.91),PVU angle(movement)(105.68±20.54)°,the intravelar segment of the levator veli palatini muscle(13.13±1.00)mm,insertion spacing(13.13±1.00)mm.and the starting angle of the levator muscle(58.0±3.3)°.In contrast,the width of the hard palate(37.5±1.43)mm,
作者
钱坤
熊竹友
谢宗玉
李光早
徐静
张莉
Qian Kun;Xiong Zhuyou;Xie Zongyu;Li Guangzao;Xu Jing;Zhang Li(Department of Plastic and Burn Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China;Department of Radiology,First Affiliated Hospital,Bengbu Medical College,233000)
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2020年第2期148-156,共9页
Chinese Journal of Plastic Surgery
关键词
磁共振成像
腭裂
腭咽
腭帆提肌
Magnetic resonance imaging
Cleft palate
Velopharyngeal
Levator veli palatini muscle
