CT在喉与喉咽肿瘤诊断中的应用

目的　探讨CT扫描在喉与喉咽癌诊断中的应用价值。方法　收集 81例由CT诊断、经手术病理证实的喉与喉咽癌患者 ,其中喉癌 73例 ,喉咽癌 8例。患者取颈过伸位 ,扫描基线平行于真声带 ,层厚 3～ 5mm (必要时 1～ 2mm) ,扫描范围包括整个喉咽和颈部各组淋巴结。增强扫描应用 65 %安其格纳芬或 3 0 0mg优维显 80～ 10 0ml。结果　喉癌的主要CT表现为会厌喉面、杓会皱壁及假声带增厚 ,或有不规则肿物突向前庭 ;声带局限性增厚隆起 ,声带固定。喉咽癌见梨状窝占位性病灶 ,环 椎间距 >2 .0cm。本组 70 %的病例伴有颈部淋巴结肿大 ,为转移灶。结论　CT扫描能够较准确作出喉癌和喉咽癌的诊断 ,以及颈部淋巴结转移灶 ,为临床治疗提供可靠依据。

Application of CT in Laryngopharyngeal Carcinoma

Objective To evaluate CT scanning in the diagnosis of laryngeal and laryngopharyngeal carcinoma. Methods Eighty one patients were diagnosed by CT,and confirmed by operation and pathologic examination. Among them,73 cases were laryngeal carcinoma,other 8 cases were laryngopharyngeal carcinoma. The patients were in hyperextension position. The base scanning line was paralleled to the vocal cord. The thickness of slices were 3-5mm,sometimes 1-2mm. The scanning scope included lymph nodes in the cervical part. 80-100ml 65% Angiografin or Ultravist (300mg) were used for the enhancement scanning. Results The main findings of laryngeal carcinoma were thickening of the laryngeal side of epiglottis,the aryepiglottic fold and false vocal cord as well as irregular mass was processed to vestibule. The local thickening and protruding of vocal cord,and the fixation of vocal cord were also depicted. The findings of laryngopharyngeal carcinoma were the mass found in piriform fossa,and the distance between cricoid cartilage and laminoplasty was more than 2.0cm. In this group,enlarged (malignant) lymph nodes were found in cervical part in 70% cases,which were metastasis lesions. Conclusion CT examination can accurately diagnose laryngeal carcinoma and laryngopharyngeal carcinoma and find the metastasis lesions of lymph node,and provide reliable basis for clinical therapy.