螺旋CT对喉咽癌的诊断及治疗前分期评价

目的 探讨螺旋CT对喉咽癌的诊断及治疗前分期价值.方法 回顾性分析45例经手术和病理证实的喉咽癌的CT表现,根据CT征象判断肿瘤的侵犯范围及其治疗前分期,并与手术结果对照.结果 梨状窝癌29例(64.4%),喉咽上区癌9例(20.0%),咽后壁癌或环后癌5例(11.2%),混合型2例(4.4%).CT扫描表现为病变平扫呈等或略低密度,增强后明显不均匀强化.咽后壁软组织增厚(杓-椎距或环-椎距增宽).梨状窝和/或喉旁间隙变窄、消失.喉移位及邻近结构受累.喉软骨破坏和颈部淋巴结转移.治疗前CT对原发肿瘤分期的准确性为82.2%(37/45).结论 CT可较准确地显示肿瘤侵犯范围及反映治疗前分期,对喉咽癌的临床治疗有很大帮助.

Evaluation of spiral CT in diagnosis and preoperative staging of the hypopharyngeal carcinoma

Objective To evaluate spiral CT scanning in diagnosing and preoperative staging of the hypopharyngeal carcinoma.Methods CT findings in 45 patients proved by operation and pathology with hypopharyngeal carcinoma were retrospectively analyzed.The tumor invasive range and staging with CT was correlated with operation-pathologic results.Results The lesion was located at pyriform sinus in 29 cases(64.4%),at the superior part of hypopharynx in 9 cases(20%),at retropharynx or postcricoid area in 5 cases(11.2%) and mixed in 2 cases(4.4%).Lesion's density was iso-or slight low-density on plain scans,and obvious inhomogeneous enhancement on enhanced scans.Retropharyngeal soft tissue was thickened and cricoid cartilage-vertebra or arytenoids cartilage-vertebra distance was widened.Pyriform sinus and/or paralargnx space were narrow or disappear.Larynx and neighboring structures were displaced and involved.Laryngeal cartilage was destructed and metastasis of cervical lymph nodes.The accuracy of tumor staging was 82.2%(37/45).Conclusion CT is useful in assessing invasive range and preoperative staging of the hypopharyngeal carcinoma which are helpful to clinical treatment.