双能CT碘图术前评估喉癌及下咽癌T分期

目的 观察双能CT碘图用于喉癌及下咽癌术前T分期的应用价值。方法 回顾性分析117例经手术病理证实的喉癌及下咽癌患者术前双能CT图像，包括41例T1期、33例T2期、31例T3期、12例T4期。根据CT碘图表现对肿瘤进行TNM分期，以手术病理结果为标准，分析CT碘图分期结果的准确率。结果 喉癌及下咽癌的双能CT碘图表现为声带或咽壁增厚、软组织肿块形成和/或病灶部位碘浓聚；根据其CT碘图的表现对各期喉癌及下咽癌进行术前T分期的准确率分别是T1期97.56%（40/41）、T2期84.85%（28/33）、T3期93.55%（29/31）、T4期91.67%（11/12）；CT碘图术前T分期的总体准确率92.31%（108/117），与术后病理分期结果的一致性良好（Kappa=0.89，P<0.05）。结论 双能CT碘图可准确显示喉癌及下咽癌的部位、形态及侵犯范围，并进行准确术前T分期。

Evaluation of T staging of laryngeal and hypopharyngeal neoplasms with dual-energy CT iodine images

Objective To explore the value of iodine image of dual-energy CT for preoperative T staging of laryngeal and hypopharyngeal neoplasms. Methods Preoperative dual-energy CT images of 117 patients with laryngeal or hypopharyngeal cancers confirmed by pathology were retrospectively analyzed, including 41 cases of stage T1, 33 cases of stage T2, 31 cases of stage T3 and 12 cases of stage T4 tumors. T staging was performed based on iodine images of dual-energy CT taken the pathological results as standards, and the accuracy of staging with CT iodine images was analyzed. Results Dual-energy CT iodine images of laryngeal and hypopharyngeal cancers showed vocal cord/pharyngeal wall thickening or the presence of soft tissue mass and/or concentrated iodine concentration at the tumor areas. The diagnostic accuracy of preoperative T staging of laryngeal and hypopharyngeal cancers was 97.56% (40/41) for T1, 84.85% (28/33) for T2, 93.55% (29/31) for T3 and 91.67% (11/12) for T4 according to CT iodine images. The overall accuracy of preoperative T staging of CT iodine images was 92.31% (108/117), which had good consistency with postoperative pathological staging results (Kappa=0.89, P<0.05). Conclusion Dual-energy CT iodine images can accurately display the location, shape and invasion range and therefore describe preoperative T staging of laryngeal and hypopharyngeal cancers.