牙頜畸形診斷中螺旋CT三維重建頭影測量的應用

周世陽 唐興艷

[摘要] 目的 主要分析將螺旋CT三維重建頭影測量方法應用于牙頜畸形患者臨床診斷中的價值，希望為牙頜畸形患者的臨床診治提高一定參考及支持。方法 該課題調查資料是方便選取2018年6—12月該醫院診治的40例牙頜畸形患者，術前對所有患者進行X線頭顱側位定位片的拍攝，同樣完成螺旋CT掃描。X線頭顱側位定位片的投影測量利用硫酸紙進行描繪完成。將所有患者的CT圖像數據保存后，利用Syngo Via后處理工作站進行三維重建，通過三維圖像完成定點，完成擬測量指標的設定，得出測量結果。結果 2D組U1-NA（mm）指標（5.15±1.23）、U1-NA（°）指標（32.16±8.22）、U1-L1指標（120.94±12.44）、L1-MP指標（97.37±8.52）與3D組對比差異有統計學意義（t=3.050、6.980、5.570、4.040，P<0.05）;2D組 MP-FH（°）指標（30.52±6.27）與3D組MP-FH（°）指標（33.94±8.26）對比差異有統計學意義（t=2.590，P<0.05）;兩組將SNA（°）指標、SNB（°）指標、ANB（°）指標、NP-FH（°）指標、Yaix（°）指標對比差異無統計學意義（P>0.05）。結論 螺旋CT三維重建頭影測量方法對牙頜畸形患者的應用中，能夠更加清晰直觀的顯示顱面骨骼的三維結構，相關指標的測量更加準確，臨床正畸術前矯治計劃的定制、矯治的預測性均有較大作用，且過程比較簡單，具有較強的操作性，值得廣泛推廣。

[關鍵詞] 螺旋CT;三維重建;頭影測量;牙頜畸形;臨床診斷;Syngo Via

[Abstract] Objective To analyze the value of applying spiral CT three-dimensional reconstruction cephalometric method to the clinical diagnosis of patients with dental and maxillofacial deformities， and hope to improve the clinical diagnosis and treatment of patients with dental and maxillofacial deformities. Methods The survey data of this project the convenienty selected of 40 patients with dental and maxillofacial malformations diagnosed in the hospital from June to December 2018. All patients were taken X-ray skull lateral positioning films before surgery， and spiral CT scans were also completed. The projection measurement of the X-ray skull lateral positioning film was completed using sulfuric acid paper. After saving the CT image data of all patients， the post-processing workstation of Syngo Via was used to perform 3D reconstruction. The 3D image was used to complete the fixed point and complete the setting of the intended measurement index to obtain the measurement results. Results The U1-NA （mm） index （5.15±1.23）， U1-NA （°） index （32.16±8.22）， U1-L1 index （120.94±12.44）， L1-MP index （97.37±8.52）， and there was difference compared with that in the 3D group. There were significant differences in group comparison （t= 3.050， 6.980， 5.570， 4.040，P<0.05）; MP-FH （°） index （30.52±6.27） in the 2D group was compared with MP-FH （°） index （33.94±8.26） in the 3D group. There was a significant difference （t= 2.590，P<0.05）; there was no statistically significant difference between the two groups in the SNA （°） index， SNB （°） index， ANB （°） index， NP-FH （°） index， and Yaix （°） index（P>0.05）. Conclusion The application of spiral CT three-dimensional reconstruction cephalometric measurement to patients with dental and maxillofacial deformities， which can more clearly and intuitively display the three-dimensional structure of craniofacial bones， and measure related indicators more accurately. The predictability has a great effect， and the process is relatively simple and has strong operability， which is worthy of widespread promotion.