喉及下咽癌采用螺旋CT增强扫描及多平面重组的应用价值

目的 探讨螺旋CT增强扫描及多平面重组(MPR)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 50例喉及下咽癌患者(原发肿瘤40例、术后评价10例)进行轴位螺旋CT平扫及三期增强扫描，同时做MPR成像。将结果与纤维喉镜、手术所见对照分析。结果 螺旋CT增强扫描轴位结合MPR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95％及97.5％；25％的病例MPR显示肿瘤侵犯的范围优于轴位；增强图像有助于判断肿瘤的侵犯范围及颈部淋巴结转移，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增强扫描轴位结合MPR图像，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。

Laryngeal and hypopharyngeal carcinomas:study of helical CT enhanced images and multiplanar reformation

Objective To evaluate the clinical applications of helical CT enhanced images and multiplanar reformation (MPR) in preoperative tumor staging and postoperative condition evaluation of laryngeal and hypopharyngeal carcinoma Methods The precontrast and three phase postcontrast helical CT scans were performed in 50 patients with laryngeal or hypopharyngeal carcinoma (primary tumor 40 cases and 10 postoperative cases in laryngeal or hypopharyngeal carcinoma), and the MPR image was generated from the volumetric data The results were compared with the findings of fiber optic laryngoscopy and surgery Results Combined with helical CT enhanced axial and MPR images, the accuracy in preoperative tumor staging and diagnosis of metastatic lymph nodes were 95% and 97 5% respectively MPR demonstrated more information about the extent of tumor than that of axial images in 25% cases The enhanced images could more clearly demonstrate the extent of tumor and detect lymphadenopathy, and the venous phase images were most useful 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 enhanced axial and MPR images can provide comprehensive information about the laryngeal and hypopharyngeal carcinoma in preoperative tumor staging and postoperative condition evaluation