喉癌MRI分期评价

目的评价ＭＲＩ在喉癌术前Ｔ分期中的价值。方法对５９例喉癌的ＭＲＩ资料进行回顾性分期，并与纤维喉镜及手术病理对照。结果ＭＲＩ对各期喉癌分期的准确性分别是：Ｔ１：９５％（２０／２１），Ｔ２：８８％（１５／１７），Ｔ３：８５％（１１／１３）Ｔ４：１００％（８／８）。纤维喉镜分期的准确性是：Ｔ１：９１％（１９／２１），Ｔ２：８８％（１５／１７），Ｔ３：４７％（８／１３），Ｔ４：１３％（１／８）。结论ＭＲＩ能准确判断会厌前间隙（ＰＥＳ）、喉旁间隙（ＰＧＳ）浸润及软骨破坏，因而可显著提高喉癌术前分期的准确性，对临床治疗方案选择具有重要意义。     

喉癌术前MRI与术后全喉切片诊断作用的前瞻性研究

本文就９例喉癌术前以纤维喉镜为主的临床检查、ＭＲＩ检查与全喉切除后连续全器官病理切片检查的结果进行了前瞻性对比研究。主要从声门下区、声带、室带、声门上区等四个平面比较，发现术前进行ＭＲＩ可清晰而较准确地显示肿瘤向会厌前间隙、声带旁间隙、喉软骨支架等部位的侵犯范围，其与术后全器官病理切片在判断病变范围方面的符合率（８８．９％）远高于纤维喉镜检查与病理的符合率（４４％）。     

喉癌MRI分期评价

目的 评价ＭＲＩ在喉癌术前Ｔ分期中的价值。方法 对５９例喉癌的ＭＲＩ资料进行回顾性分期，并与纤维喉镜及手术病理对照。结果 ＭＲＩ对各期喉癌分期的准确性分别是：Ｔ１：９５％（２０／２１），Ｔ２：８８％（１５／１７），Ｔ３：８５％（１１／１３）Ｔ４：１００％（８／８）。纤维喉镜分期的准确性是：Ｔ１：９１％（１９／２１），Ｔ２：８８％（１５／１７），Ｔ３：４７％（８／１３），Ｔ４：１３％（１／８）。结论     

咽旁隙肿瘤的MRI诊断

目的 探讨咽旁隙肿瘤的ＭＲＩ表现特点及其临床诊断价值。方法 对２９例手术病理证实的咽旁隙肿瘤的ＭＲＩ征象进行分析，并以手术和病理结果相比较。结果 ＭＲＩ对咽旁隙肿瘤定位和定性准确；不同组织来源的肿瘤与周围组织的关系在ＭＲＩ特征上有不同；良性肿瘤界限清楚，信号分布均匀，Ｔ１ＷＩ主要表现为中等信号；恶性肿瘤信号分布不均匀，Ｔ１ＷＩ表现为低中信号。结论 本研究结果证实，ＭＲＩ在诊断咽旁隙肿瘤中有其自身的     

喉癌的磁共振成像表现（附24例分析）

分析２４例喉癌术前磁共振成像（ＭＲＩ）所见，并与手术、病理对照。ＭＲＩ清楚地显示了喉癌的三维形态，使能正确判断会厌前间隙（ＰＥＳ）、喉旁间隙（ＰＧＳ）侵犯及喉软骨破坏，这对估计肿瘤能否切除及手术方式的选择具有重要参考意义。     

喉癌的磁共振成像表现：附24例分析

分析２４例喉癌术前磁共振成像（ＭＲＩ）所见，并与手术、病理对照。ＭＲＩ清楚地显示了喉癌的三维形态，使能正确判断会厌前间隙（ＰＥＳ）、喉旁间隙（ＰＧＳ）侵犯及喉软骨破坏，这对估计肿瘤能否切除及手术方式的选择具有重要参考意义。     

基层医院应用纤维喉镜诊断喉癌的意义（摘要）

基层医院应用纤维喉镜诊断喉癌的意义（摘要）刘群旺，曹佳利，赵兰兰自１９９２年１２月～１９９３年５月应用纤维喉镜对２１８例有声嘶的中老年患者进行喉检查，共发现喉癌患者２４例，年龄３８～７４岁，男１９，女５；声门上型６例，声门型１７例，声门下型１例，经病...     

喉癌TNM分级分期与喉部分切除术

传统喉部分切除术已发展成为现代喉癌功能性外科手术，既能安全、有效地根除喉癌病灶，又能很好地保留或重建喉的功能。各种喉部分切除术的长期肿瘤学结果和功能性结果已得到大量研究，它们与喉癌TNM分类分期有着密切的关系；自1958年国际抗癌联盟（UICC）首次对喉癌进行分期后，近40多年来UICC的分类分期得到很大的发展，喉癌TNM分类分期已用来比较和分析各种喉癌的侵及范围，协助临床医师作出合理的治疗计划，判断预后，评估治疗效果，同时还方便各治疗中心进行相互交流。以往各种喉部分切除术的适应证大都依据喉癌TNM分类分期进行选择，每一种喉部分切除术均有其各自相适应的手术适应证和禁忌证；如T1、12声门癌选择喉部分切除术，而T3、T4声门癌则大都选择喉全切除术。然而根据手术适应证和禁忌证的变迁，靠近喉前部的肿瘤，即使是T3或T4仍可选择喉部分切除术，如喉环状软骨上部分切除术。     

多层螺旋CT增强扫描在喉癌诊断及临床分期中的应用价值

目的：探讨将多层螺旋CT增强扫描的横断面图像、多平面重建图像（MPR）和仿真喉镜（VE）图像结合起来（联合图像）在喉癌术前诊断及TNM分期中的应用价值。方法：①32例拟诊喉癌患者行术前前赡性多层螺旋CT增强扫描并行MPR和VE处理。②采用双盲法阅片，将单一横断面图像、MPR和VE联合图像分别作出CT诊断。③临床医师结合CT图像，分别进行国际抗癌协会（UICC）TNM临床分期。④完成喉癌手术，根据病理和电子喉镜确定病理学分期，将2种方法（横断面图像和MPR）的分期结果进行比较。结果：32例喉癌中，联合图像对评价室带、声带、前连合、声门下、声门旁间隙、会厌前间隙、甲状软骨、喉外结构受侵的准确率为98．3％，而横断面图像为91.3％，两者比较其准确率有统计学意义（X^2=20．624，P〈O．01）；横断面图像对喉癌分期的准确率为81．3％，联合图像为93．8％，两者比较差异无统计学意义（P〉O．05）。结论：多层螺旋CT增强扫描的MPR和VE是横断面图像很好的补充，能够帮助提高喉癌诊断水平，横断面图像和联合图像对于喉癌术前临床分期无明显差别。     

支撑喉镜下YAG激光治疗喉部疾病(摘要)

支撑喉镜下ＹＡＧ激光治疗喉部疾病（摘要）李凤琴，邵洪武本文报告在支撑喉镜下应用ＹＡＧ激光对８０例喉部疾患进行治疗的临床观察，其中声带息肉５８例、喉角化症８例、喉乳头状瘤６例、喉癌（声门型Ｔ１Ｎ０Ｍ０）３例、喉癌术后喉狭窄５例，均取得较好的临床疗效。认...     

T staging of the laryngohypopharyngeal carcinoma. A 7-year multidisciplinary experience

Sixty-six whole-organ sectioned, nonirradiated, laryngopharyngectomy specimens that were removed because of cancer during a 7-year period were uniformly examined to determine the accuracy of perioperative T staging by high-resolution computed tomography (CT) and clinical evaluation (indirect-direct laryngoscopy) by comparing this preoperative staging with the postsurgical pathologic staging. The accuracy of the clinical vs CT staging for laryngeal carcinomas was 58.8% vs 70.6%, whereas the accuracy of the staging by combination of the two modalities was 88.2%. Combined staging modalities showed the same accuracy for laryngeal and hypopharyngeal carcinomas (88.2%), whereas clinical staging accuracy for hypopharyngeal carcinomas was lower (52.9%) and CT accuracy was higher (82.4%) than that observed for laryngeal carcinomas. In the majority of the cases that were staged inaccurately, the error was one of under-estimation: in particular, tumors confined to the mucosa and early infiltration of laryngeal fat spaces were not detected by CT.     

MRI和MSCT在喉癌术前分期中的对比分析

目的：探讨MRI和MSCT增强扫描横断、多平面重建图像在喉癌TNM中的价值。方法：37例患者行MRI检查,并有横断位、冠状位、矢状位成像;35例患者行MSCT扫描,横断位、多平面成像;其中28例进行MRI和MSCT扫描。所有患者均有病理证实。观察并对比其各部位病变显示的准确度,对比分析37例MRI患者和35例MSCT患者的影像表现在诊断淋巴结转移方面的差异性以及在TNM分期中的差异。结果：在28例行MRI和MSCT患者中,MRI在观察会厌前间隙、喉旁间隙、舌根、颈外组织、声带方面有较好的准确度,在前两组TNM分期中,T1期两者准确度没有差别,随着分期增高MRI准确度增高,最后分期比较两者差异有统计学意义（P〈0.05）。在判断淋巴结转移方面MSCT的敏感性、特异性、准确度较MRI略高。结论：MRI和MSCT在喉癌患者术前T分级中准确度均高,MRI在观察会厌前间隙、喉旁间隙、舌根、颈外组织、声带部位上有较好的准确度,而在淋巴结转移方面MSCT具有较可靠的准确度,T1分期两者无差异性,T2～4期两者有差异性,MRI较MSCT更准确。     

Impact of magnetic resonance imaging and computed tomography on the staging of laryngeal cancer

This retrospective study quantitatively assessed the effects of magnetic resonance imaging (MRI) and computed tomography (CT) on the staging of laryngeal cancer. A blind comparison between CT and MRI was made in a group of previously untreated patients with squamous cell carcinomas of the larynx. From June 1992 to November 1993, 29 patients were eligible for study. Of these, 14 patients (48%) had supraglottic lesions, 11 patients (40%) had glottic lesions and 4 patients (14%) had both. No subglottic lesions were seen. The data suggest that clinical staging of laryngeal tumors is inadequate. MRI proved superior to CT for staging tumors, especially those confined to the supraglottis. Nevertheless, clinically staged T1 or T2 lesions could be adequately assessed by CT alone. Findings also indicate that MRI should be reserved for T3 or T4 clinically staged lesions. Furthermore, most nodal disease can be staged by CT.Presented at the combined meeting of the Society of Head and Neck Surgeons and the European Organization for Research and Treatment of Cancer, Paris, France, 25–28 May 1994     

声门上型喉癌临床和病理分级对照分析

为了探讨声门上型喉癌临床分级的准确性，采用５３例声门上型喉癌全喉连续切片标本进行临床和病理分级的对照分析，结果发现，临床分级低估率为２４．５％，其中临床Ｔ２，Ｔ３病变低估率分别为５４．５％，３３．３％，临床分级无高估者，未能判定会厌前向隙和甲状软骨受累是临床分级被低估的重要因素，提示声门上型喉癌早期病变手术时，应常规切除厌前间隙，前连合区广泛受累或声门旁间隙广泛受累同时半有甲状软骨骨化时，应警惕甲     

Diffusion-weighted MRI in diagnosing thyroid cartilage invasion in laryngeal carcinoma

The diagnosis of thyroid cartilage invasion in patients presenting with laryngeal carcinoma is essential for pre-therapeutic staging. Compared to CT, diffusion-weighted magnetic resonance imaging (MRI) has a similar ability to define the interface between fat and tumor, but is superior for assessing muscle and cartilage invasion. Diffusion-weighted MRI may be indicated if there are equivocal findings in the CT, including possible cartilage invasion. The aim of this study is to assess the validity of diffusion-weighted MRI in predicting inner and outer thyroid cartilage laminae invasion in patients with laryngeal carcinoma. A prospective study was carried out between August 2011 and May 2013. The study included 26 patients. Twenty-three patients underwent total laryngectomy and three patients underwent partial laryngectomy. Histopathology reports of resected specimens and pre-operative staging were blind to the consultant radiologist who reviewed the scans to comment on thyroid cartilage invasion with special emphasis on inner and outer lamina invasion by conventional MRI criteria, contrast enhancement and DWI. The sensitivity, specificity, efficiency (correct classification rate), and positive and negative predictive values of MRI for identification of inner thyroid lamina invasion were: 93, 82, 88, 88 and 90 % respectively, while those of outer thyroid lamina invasion were: 85, 85, 85, 85 and 85 %, respectively. Diffusion-weighted MRI showed high validity and precision in detecting inner and outer thyroid lamina invasion. This can have an important impact on the decision making for management of laryngeal carcinoma.     

Stridor in a newborn caused by infantile myofibromatosis—A case review

Infantile myofibromatosis is a common fibrous tumor of infancy, however still considered a rarity. A newborn boy was examined due to inspiratory stridor and subcostal retractions since birth. Several subcutaneous nodules were present on the trunk and legs. Transnasal fiberoptic laryngoscopy and trachea-laryngoscopy showed discrete edema of the anterior part of the vocal cords but no other apparent abnormality. MRI raised suspicion of a laryngeal tumor. Through an external laryngofissure a lesion extending from the right hemilarynx was exposed and excised in fractions. Pathological examination showed infantile myofibromatosis.Stridor in newborns is frequently caused by congenital laryngeal anomalies, i.e. laryngomalacia but a neoplastic process should be considered as a differential diagnosis.     

喉咽、颈段食管癌的磁共振表现

通过对１７例喉咽、颈食管癌的食管吞钡造影与磁共振（ＭＲＩ）检查结果进行对比分析。资料表明，食管吞钡造影不能显示肿物浸润周围组织结构的情况，故难作出正确的ＴＮＭ分期：ＭＲＩ是显示肿瘤三维形态、肿瘤与邻近结构的有效和可靠的技术手段。提示ＭＲＩ地喉因、颈段食管癌的诊断、ＴＮＭ分期和技术治疗的选择，均具有重要的指导意义。     

人工智能技术在喉癌诊疗领域中的应用

喉癌是头颈部最常见的恶性肿瘤之一，而喉部是人体发声、通气的重要器官，提高喉癌的诊疗水平可显著改善喉癌患者的预后和生活质量。近年，随着科技的发展和各种大型数据库的建立，人工智能技术在喉癌各诊疗领域的研究不断深入，并在辅助图像识别、病理成像诊断、机器人辅助手术、多因素预后预测等方面取得了一定成果。本文就人工智能技术在喉癌的早期筛查、诊断、治疗和预后预测等领域中的研究进展进行综述，探讨目前人工智能技术在喉癌诊疗中的应用局限与不足，并展望其未来的发展方向。