A Study On Two And Three Dimensional Measurement Of Upper Airway Of Obstructive Sleep Apnea-hypopnea Syndrome

Objective:1、Objective to study whether there are differences in the measurement results of the same anatomical part of the upper airway by two-dimensional CBCT(CCB)and two-dimensional cranial lateral slice(LCR),and to analyze the reliability of the two measurement methods.2、The difference between the three different measurement softwares for the same anatomic location of the upper airway of the same patient is studied,and the reliability of the three measurement softwares is analyzed.3、Objective to study the difference between the spiral CT(MSCT)and cone beam CT(CBCT)of the same patient in measuring the volume and cross-sectional area of the same part of the upper airway,and to make two CT reliability analysis.4、Objective to study the two-dimensional and three-dimensional measurement of upper airway in CCB and CBCT of normal occlusion volunteers and OSAHS patients,and analyze the correlation between all measurements and AHI and SPO2 in PSG.Materials and Methods:1、Transforming the CBCT of individual normal occlusion into two-dimensional radiographs and lateral cephalometric radiographs,and then respectively import the radiographs into Winceph8.0 to measure the airway distance;each tester is measured for3 times;calculate the intra-class correlation coefficient,paired t test of variance in order by the utilization of SPSS24.0 statistical software to test the reliability and the statistical significance of different measuring methods.2、Transforming the CBCT of individual normal occlusion into mimics17.0,dolphin11.8,and invivo5.1 to measure the area and the volume of airway;each tester is measured for 3 times;calculate the intra-class correlation coefficient,two way analysisof variance in order by the utilization of SPSS24.0 statistical software to test the reliability and the statistical significance of different measuring methods.3、Transforming the spiral CT and cone-beam CT of OSAHS patients into the software with highest intra-class correlation coefficient to measure the area and the volume of airway;each tester will be measured for 3 times;calculate the intra-class correlation coefficient,paired t test of variance in order by the utilization of SPSS24.0statistical software to test the reliability and the statistical significance of different measuring methods.4、The individual normal occlusion of volunteers and patients with OSAHS CCB into Winceph8.0 in upper airway sagittal distance measurement;upper airway volume and cross-sectional area measurements in the individual normal occlusion volunteers and OSAHS patients CBCT were introduced into mimics17.0;using SPSS24.0 statistical software,independent t test to test the differences of measurement method;correlation of person correlation analysis with AHI and SPO2.Results:1、When shifting the CBCT of individual normal occlusion into two-dimensional radiographs and lateral cephalometric radiographs to measure the upper airway and then using the results to pair t test finding that there are statistical differences among PNS-Ba、PNS-Ad1、H-C3、H-FH and measuring 3 times for each project,ICC values are all greater than 0.75,indicating the reliability of both measuring methods are relatively high.However,when transforming CBCT was into a two-dimensional radiograph to an average of 0.930,while the ones for lateral cephalometric radiographs are 0.830,indicating that the reliability for CBCT transforming into two-dimensional radiographs is higher than that of the lateral cephalometric radiographs.2、 When transforming the CBCT of individual normal occlusion into mimics17.0,dolphin11.8,and invivo5.1 to measure the area and the volume of airway,there is no statistical difference by two way analysis of variance,indicating that the measuring results of mimics17.0,dolphin11.8,and invivo5.1 are basically the same,therefore,they are comparable.Each tester is measured for 3 times by the same software respectively,and the ICC values are all greater than 0.75,showing that the reliability of the three measuring methods is relatively high.But the average ICC value of mimics was 0.944,the average ICC value of dolphin is 0.889 and the average ICC value of invivo is 0.807.Hence,the reliability of the mimics ranks first,dolphin the second,and invivo the last.3、When transforming the spiral CT and cone-beam CT of OSAHS patients into the software(mimics)with highest intra-class correlation coefficient to measure the area and the volume of airway and examining the results by paired t test,there is no statistical difference in nasopharynx and glossopharyngeal airway volume,but there is statistical difference in oropharynx in both surface area and cross-sectional area.This shows that the CT of two different positions have no change in the volume of nasopharynx and glossopharyngeal airway though,the airway morphology changes.Each tester is measured for 3 times by the same CT respectively,finding that ICC values are all greater than 0.75,and the average ICC value of CBCT is 0.933,the average ICC value of MSCT is 0.921,indicating that the reliability of the two measuring methods are relatively high with no great difference.4、OSAHS patients and individual normal occlusion CCB volunteers were introduced into Winceph 8 in upper airway distance measurement,the results are consistent with normal distribution,the average of three measurements,then the independent t test on them,PNS-UPW,SPP-SPPW,U-MPW and TB-TPPW have significant difference;upper airway volume and the cross-sectional area of the measurement in CBCT were introduced into mimics17.0;data to conform to normal distribution,the average of three measurements,then the independent t test,found that all the experimental results of P were statistically significant difference;analysis method measurement index and PSG OSAHS in patients with AHI and SPO2 values of correlation analysis by the person phase,the results showed that AHI was negatively correlated with S5,S6,U-MPW,TB-TPPW;SPO2 with S3,H-FH and V3 values were positively correlated,negatively correlated with H-C3,and there were significant differences.Conclusion:1、When transforming the individual normal occlusion CBCT volunteers into two-dimensional radiographs and cephalometric radiographs,it was found that there is statistical difference in bone landmarks measurement and there is no difference in soft tissue landmarks;the reliability of the two measurement methods were high,but CBCT repeatability into two-dimensional flat plate is higher than the head lateral radiographs;2、Individual normal occlusion CBCT volunteers were introduced into mimics17.0,dolphin11.8 and invivo5.1,finding no significant differences between the six indexes;and the reliability of measuring methods of three kinds of software are all high,but mimics repeatability is the highest,followed by dolphin,while invivo was the lowest;3、The OSAHS patients with spiral CT and cone beam CT measurements showed no statistically significant difference between the nasopharynx and glossopharyngeal airway volume,but there is statistical difference in oropharyngeal airway volume as well as their surface area and cross sectional area.The reliability and repeatability of the two measurement methods are both high,and there is not much difference between them.4、Soft tissue two-dimensional measurement OSAHS patients and individual normal occlusion were statistically,nine indexes had significant difference in three dimensional measurement;the AHI value was negatively correlated with the surface area and loss distance of the oropharyngeal and glossopharyngeal segments.The SPO2 value was positively correlated with the volume and cross section of the glossopharyngeal segment,the vertical distance of the hyoid bone,and negative correlation with the horizontal distance of the hyoid bone,and there were statistical differences.