牙颌畸形诊断中螺旋CT三维重建头影测量的应用

周世阳 唐兴艳

[摘要] 目的 主要分析將螺旋CT三维重建头影测量方法应用于牙颌畸形患者临床诊断中的价值，希望为牙颌畸形患者的临床诊治提高一定参考及支持。方法 该课题调查资料是方便选取2018年6—12月该医院诊治的40例牙颌畸形患者，术前对所有患者进行X线头颅侧位定位片的拍摄，同样完成螺旋CT扫描。X线头颅侧位定位片的投影测量利用硫酸纸进行描绘完成。将所有患者的CT图像数据保存后，利用Syngo Via后处理工作站进行三维重建，通过三维图像完成定点，完成拟测量指标的设定，得出测量结果。结果 2D组U1-NA（mm）指标（5.15±1.23）、U1-NA（°）指标（32.16±8.22）、U1-L1指标（120.94±12.44）、L1-MP指标（97.37±8.52）与3D组对比差异有统计学意义（t=3.050、6.980、5.570、4.040，P<0.05）;2D组 MP-FH（°）指标（30.52±6.27）与3D组MP-FH（°）指标（33.94±8.26）对比差异有统计学意义（t=2.590，P<0.05）;两组将SNA（°）指标、SNB（°）指标、ANB（°）指标、NP-FH（°）指标、Yaix（°）指标对比差异无统计学意义（P>0.05）。结论 螺旋CT三维重建头影测量方法对牙颌畸形患者的应用中，能够更加清晰直观的显示颅面骨骼的三维结构，相关指标的测量更加准确，临床正畸术前矫治计划的定制、矫治的预测性均有较大作用，且过程比较简单，具有较强的操作性，值得广泛推广。

[关键词] 螺旋CT;三维重建;头影测量;牙颌畸形;临床诊断;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.