在電腦斷層影像上鼻息肉與上頷骨之量化分析

Abstract

慢性鼻竇炎是常見的醫療問題之一。鼻息肉是引起慢性鼻竇炎的主要因素。鼻息肉生長在鼻腔及鼻竇中，鼻息肉的生長可能會導致鼻腔或上頷骨的擴大。因此，為了得到量化分析，自動計算上頷骨的體積是需要被提出來的。首先，在電腦斷層影像上，將上頷竇偵測出來，並確定周圍上頷骨的位置。接著在一系列電腦斷層影像中，計算上頷骨的體積。最後，探討上頷骨的體積比與鼻息肉占上頷竇的比例的相關性並驗證自動計算的體積比與手動計算的體積比之間是否有顯著性的差異，接著，比較他們之間的效率。實驗結果，上側及外側之上頷骨體積比與鼻息肉占上頷竇的比例，兩者的關係為正相關，相關係數分別為0.554和0.316。此外，自動計算的體積比與手動計算的體積比，在上側及外側的上頷骨中沒有明顯性的差異。再者，在臨床使用上，骨頭體積可藉由鼻息肉在上頷竇中的比例來預測，除此之外，自動計算體積比起手動計算體積更快速，約只需要手動時間的四分之一。

Chronic rhinosinusitis (CRS) is a common health care problem. Nasal polyps are the main factor to make the sinuses blocked causing the CRS and they grow up in the sinuses and even result in the expansion of anterior maxilla. Therefore, an automatic segmentation followed by quantitative measurement is proposed to obtain the volume of maxillary bone. First, the maxillary sinuses were detected and the maxillary bones were identified. The next step was calculating the volume of maxillary bones from a series of computed tomography images. As a result, the volume ratio of maxillary bones and the proportion of the nasal polyps in maxillary sinus was a moderate correlation=0.554 for the superior bones and a fair correlation=0.316 for the lateral bones. Considering the accuracy and efficiency, the proposed automatic procedure was compared to a manual procedure and obtained no significant differences (p-value>0.05). For the clinical use, the proportion of the nasal polyps in the maxillary sinus can predict the growing trend of the bone volume based on the proposed automatic procedure with much shorter time about one minute than the manual procedure.