喉及下咽癌螺旋CT三期增强扫描的临床应用价值

目的:探讨螺旋CT三期增强扫描在喉及下咽癌术前分期及术后评价中的临床应用价值。方法:64例喉及下咽癌患者(原发肿瘤49例、术后评价15例)进行螺旋CT平扫及三期增强扫描。将结果并与纤维喉镜、手术所见对照分析。结果:螺旋CT平扫结合三期增强扫描图像对术前肿瘤分期和诊断颈部淋巴结转移的准确性分别是93.8%及95.9%;增强后肿瘤边界较增强前清晰,有助于肿瘤侵犯范围的判断,对颈部淋巴结转移的检测和判定增强扫描也明显优于平扫图像,静脉期图像对肿瘤的分期帮助最大;螺旋CT三期增强扫描有利于评价喉及下咽癌的术后状况。结论:螺旋CT平扫结合静脉期增强扫描可以更完整地提供喉及下咽癌术前分期及术后评价的全面资料。

Clinical application value of helical CT three-phases enhanced images in laryngeal and hypopharyngeal carcinoma

Objective:To evaluate the clinical applications of helical CT three-phases enhanced images in preoperative tumor staging and the postoperative condition evaluation of laryngeal and hypopharyngeal carcinoma.Methods:The precontrast and three-phase postcontrast helical CT scans were performed in 64 patients with laryngeal or hypopharyngeal carcinoma(primary tumor 49 cases and postoperative evaluation 15 cases).The results were compared with the findings of fiber optic laryngoscopy and surgery.Results:Combined with helical CT precontrast and three-phases enhanced images,the accuracy in preoperative tumor staging and diagnosis of metastatic lymph nodes were 93.9% and 95.9% respectively.On enhanced images,the tumor margin was showed more clearly than that the precontrast images,and was useful in demonstrating the extent of tumor and detect lymphadenopathy,and the venous-phase images had the most valuable in the preoperative tumor staging.Helical CT three-phases enhanced images were in favor of evaluating the postoperative condition of the laryngeal and hypopharyngeal carcinoma.Conclusion:The combined interpretation of helical CT precontrast and venous-phase images can provide comprehensive information about the laryngeal and hypopharyngeal carcinoma in preoperative tumor staging and the postoperative condition evaluation.