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Childhood Image Measuring Pharyngeal Tonsil Hyperplasia and Maxillary Sinusitis Combined Experimental Study on the Correlation

Author: LiQiang
Tutor: CuiJianLing
School: Hebei Medical University
Course: Medical Imaging and Nuclear Medicine
Keywords: Pharyngeal tonsil proliferate CT X-ray A/N ratio maxillarysinusitis C/D ratio correlation
CLC: R766
Type: Master's thesis
Year: 2014
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Abstract


Objective:1Study of childhood pharyngeal tonsil hyperplasia imaging measurementmethods and various imaging methods if there are differences.2Correlation curves up and down up and down the path with the largestdiameter of the nasopharynx ratio study normal and hyperplastic group ofchildren aged2to15thickest of the pharyngeal tonsils (A/N) and its age.3Drive up and down and up and down in normal children aged2-15thickest pharyngeal tonsil and nasopharynx maximum diameter verticaldiameter ratio (A/N) range and2~15year-old children with pharyngeal tonsilhyperplasia of the thickest nasopharynx maximum vertical diameter ratio (A/N)range.4Down through the pharyngeal tonsil hyperplasia in children withpharyngeal tonsils thickest diameter and nasopharynx maximum verticaldiameter ratio (A/N) measurement and calculation, study of children aged2~15pharyngeal tonsil hyperplasia degree image credits.5Correlation of pharyngeal tonsils of children between the maxillaryhyperplasia.6Research pharyngeal tonsil hyperplasia image credits degrees (Ⅰ, Ⅱ,Ⅲ degree) and children maxillary sinusitis severity score (0to5points)correlation.Methods:1Grouping research subjects-Choose November2012to November2013and after menstruation related imaging confirmed100cases of childrenin Ophthalmic Hospital of Hebei Province diagnosed by clinical examinationpharyngeal tonsil hyperplasia patients studied, the group hyperplasia; choose by ENT pharyngeal tonsil normal clinical examination and confirmed byimaging the100normal children as controls, the group was the control group.2Selecting and scanning equipment to determine the baseline study-①Nasopharynx oblique coronal CT: Use the German company SiemensEmotion joyous systemic single-slice spiral CT scanner for childrennasopharynx oblique coronal scan, the CT image positioning on delineationbaseline, baseline selection method is to first find the point in the occipital andsphenoid positioning like, in addition to find the most bumps pharyngealtonsils, the sphenoid and occipital binding sites and pharyngeal tonsils mostbump connection to the connection to drill baseline scan.②Paranasalsinuses Axial CT: Use the German company Siemens Emotion single slicespiral CT joyous body scanners perform cross-sectional scans of children withsinus delineate baseline positioning on CT images, scanning plane parallel tothe baseline and palate.③Nasopharyngeal lateral X-ray: South Koreancompanies use MIS produced MISDR0808D18type digital X-ray machine onthe part of children with nasopharyngeal lateral DR Photography.3Children thickest pharyngeal tonsil and nasopharynx maximum verticaldiameter vertical diameter ratio (A/N) measurement method-①In thenasopharynx oblique coronal CT, X-rays directly because the vertical crosssection through the pharyngeal tonsils maximum, so select the pharyngealtonsils maximum level measured thickness of the pharyngeal tonsils,determine the value of a, continue to measure the diameter of the upper andlower levels of the nasopharynx data to determine N values. Calculate the A/Nratio.②For children ages too small, the line oblique coronal CT scan reallysubstandard author on nasopharyngeal lateral digital X-ray films, mainly tovisually measure the maximum vertical diameter of the pharyngeal tonsilsmaximum vertical diameter and nasopharynx, and is a kind of a roughcalculation of the pharyngeal tonsils A/N ratio method.4CT diagnosis of maxillary sinusitis and severity of radiographic score-CT maxillary sinuses characteristic performance that can be seen in the softtissue density, density substantially uniform. The CT machine designated maxillary sinus cavity ring soft tissue volume of the maxillary sinus should alldisplay level measurement loop scheme, and then draw the circle of allbilateral maxillary soft tissue measured and recorded as the volume of the Cvalue, all aspects of the child while maxillary sinus volume circle draw all thecircles on both sides of the maxillary sinuses all levels of planning and theresulting volume recorded as D values, the ratio C/D can objectively reflectthe maxillary sinusitis range of severity. Range of C/D ratio is0≤C/D≤1,C/D ratio can be used to maxillary sinusitis radiographic severity score.5Statistical analysis-①Taken in accordance with a specific timeperiod20children were digitized X-ray radiographs of the nasopharynx andnasopharyngeal oblique coronal CT scan imaging were measured in two waysthe results of A/N ratio, using paired samples t test, to observe these twoimaging modalities in the pharyngeal tonsils measuring hyperplasia A/N ratioof whether the differences.②For pharyngeal tonsil A/N ratio, the hyperplasiagroup and normal group measured the A/N ratio of the two-sample t test,setting P <0.01was considered statistically significant.③For the100casesof children with hyperplasia will reflect the severity of maxillary sinusitis C/Dratio in the group of children with pharyngeal tonsils A/N ratio compared to astraight line correlation analysis, calculated Pearson correlation coefficient r.④Analysis hyperplasia pharyngeal tonsil hyperplasia of maxillary sinusitiscomplicated by their scores rank correlation between the severity score.Results:1Taken in accordance with a specific time period20children weredigitized X-ray radiographs of the nasopharynx and nasopharyngeal obliquecoronal CT scan imaging were measured in two ways the results of A/N ratio,using paired samples t test, the results showed no significant difference in thenasopharynx of digital X-ray measurements on lateral radiographs A/N andnasopharynx oblique coronal CT scan of the A/N of the measurement results.2Normal children A/N ratio of the general trend of the age chart indicates,A/N ratio of the highest peak in the age of5, A/N ratio of the existence of theplatform in the rate of decline slowed down between10to12years old. 3Pharyngeal tonsil hyperplasia group and normal group A/N ratio of thetwo-sample t test, the difference was significant statistically significant.4Combined pharyngeal tonsil nasopharyngoscopy or indirectlaryngoscopy indexing, A/N ratio of0.32to0.63as normal, A/N ratio in therange of0.64to0.75when the pharyngeal tonsil mild hyperplasia (I degree),A/N ratio in the range of0.76to0.85when the pharyngeal tonsil moderatehyperplasia (II degree), A/N ratio is greater than0.85for the pharyngealtonsils severe hyperplasia.5Pharyngeal tonsil hyperplasia in children with A/N ratio and the C/Dratio do linear correlation analysis, the results showed a statisticallysignificant.6Correlation between the use of the pharyngeal tonsil hyperplasiaindexing and C/D ratio between the scores spearman rank correlation analysisand correspondence analysis showed significant correlation between its.Conclusions:1Pharyngeal tonsil hyperplasia imaging method for a variety of classicnasopharyngeal lateral X-ray measurement and oblique coronal CT scan, thetwo comparison measurements showed no difference.2Based pharyngeal tonsil hyperplasia related images A/N measurement ofobjective and quantitative evaluation of the degree of pharyngeal tonsilhyperplasia provide a reliable basis.3Normal children A/N ratio trends show scattergrams of age, themaximum proportion of the pharyngeal tonsil nasopharynx share is about5years old, and the variation in the presence of the platform10to12years old.4Pharyngeal tonsils A/N ratio of normal to0.32~0.63, A/N ratio between0.64~0.75pharyngeal tonsil mild hyperplasia, A/N ratio between0.76~0.85moderate hyperplasia of the pharyngeal tonsils, A/N when the ratio is greaterthan0.85for the pharyngeal tonsils severe hyperplasia. Pharyngeal tonsilremoval surgery indications for A/N ratio is greater than0.76and childrenwith significant symptoms of airway obstruction.5There was a positive correlation with the degree of degree child maxillary hyperplasia pharyngeal tonsil children.6There is a significant correlation between the proliferation of images ofchildren pharyngeal tonsil credit degree and extent of child sinus inflammationscore.

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