MRI在喉癌及下咽癌术前T分期中的价值

目的 探讨MRI在喉癌及下咽癌术前T分期中的价值。方法 回顾性分析40例经手术病理证实的喉癌、下咽癌患者MRI图像，根据MRI表现对肿瘤进行T分期，并将MRI分期结果与手术病理检查结果相对照。结果 喉癌及下咽癌MRI表现为声带/咽壁增厚或软组织肿块形成。MRI诊断其侵犯周围结构的敏感性为95.4%（83/87），阳性预测值为89.2%（83/93），假阴性率为4.6%（4/87）。MRI对各期喉癌及下咽癌术前T分期的准确率分别是T₁期 100%（1/1），T₂ 期80%（12/15），T₃ 期83.3%（5/6），T₄ 期100%（18/18），总准确率为90%（36/40），MRI术前T分期与病理分级的一致性具有统计学意义（K＝0.843，P＜0.05）。结论 MRI能准确地显示喉癌及下咽癌的部位、形态及侵犯范围，其术前T分期与病理分级一致性好，具有重要的诊断价值。

MRI-based T staging of laryngeal and hypopharyngeal cancers

Objective  To assess the value of MRI for preoperative T staging of laryngeal and hypopharyngeal cancers. Methods The laryngeal or hypopharyngeal cancer of 40 patients with pathology-confirmed diagnoses were retrospectively analyzed and staged based on magnetic resonance images. MRI-based staging was compared with pathology-based staging. Results MRI of laryngeal and hypopharyngeal cancers showed vocal cord/pharyngeal wall thickening or the presence of a soft tissue mass. Sensitivity of MRI for assessing invasion was 95.4%（83/87） and positive predictive value was 89.2%（83/93），while the technique failed to detect 4.6% cases of invasion （4/87）. The diagnostic accuracy of MRI for each preoperative T stage was 100%（1/1） for T₁，80%（12/15） for T₂：， 83.3%（5/6） for T₃，and 100% （18/18） for T₄. Overall accuracy was 90% （36/40）. Paired test results showed Kappa=0.843（P<0.05）， indicating good consistency between preoperative MRI staging and pathological staging. Conclusion MRI can reveal the location， shape and extension of laryngeal and hypopharyngeal tumors， suggesting usefulness in preoperative T staging.