螺旋CT多平面重组技术在喉癌诊断中的价值

The significance of multi-slice helical CT multiplanar reconstruction in the diagnoses of laryngeal carcinoma

目的探讨螺旋 CT 多平面重组技术(MPR)在喉癌诊断中的意义。方法 35例拟诊喉癌患者行术前 CT 检查并行 MPR 图像后处理,将横断面、MPR 及横断面联合 MPR 图像诊断结果分别与术后病理切片的病变范围进行对照,应用卡方检验进行统计学处理。结果对前联合受侵的评价,横断面、MPR、横断面联合 MPR 3组图像准确性分别为82.9%、68.6%和91.4%,差异有统计学意义(P<0.05),其中,联合图像优于 MPR 图像(P<0.05)。在评价喉旁间隙受侵方面,3组图像准确性分别为91.4%、68.6%和94.3%,差异有统计学意义(P<0.05),其中,横断面及联合图像准确性均高于 MPR 图像(P 值均<0.05)。3组图像对评价甲状软骨受侵准确性分别为94.3%、77.1%和97.1%,差异有统计学意义(P<0.05),其中,横断面与 MPR 之间,MPR 与联合图像之间差异有统计学意义(P 值均<0.05);对会厌、杓会厌皱襞、声带、室带、会厌前间隙、梨状窝、杓状软骨及喉外受侵的评价,3组图像差异无统计学意义(P>0.05),但横断面联合 MPR 图像对判断各结构受侵具有较高的敏感性、特异性和准确性。结论螺旋 CT 横断面图像能够很好显示肿瘤的形态、大小、侵犯范围及颈部淋巴结转移,MPR 较横断面图像更全面直观地显示肿瘤的形态及范围,是对常规轴面图像的有益补充。横断面联合 MPR 能提高喉癌诊断符合率。

Objective To evaluate the significance of multi-slice helical CT with multiplanar reconstruction in laryngeal carcinoma. Methods Thirty-five patients with laryngeal carcinoma were studied by helical CT, MPR were subsequently done. The lesion extent of the axial image findings, MPR findings and the combined image findings were compared with the pathological results respectively. The data were statistically analyzed. Results In the evaluation of the anterior commissure, the axial image findings, MPR findings and the combined image findings were 82.9% , 68.6% and 91.4% in accuracy respectively, the results were statistically different （P 〈 0.05 ）. The combined images were superior to MPR images in accuracy （91.4% vs. 68.6% ） , the results were statistically different （P 〈 0. 05 ）. In the evaluation of the paraglottic space, the three group findings were 91.4% , 68.6% and 94. 3% in accuracy respectively, the results were statistically different （ P 〈 0. 05 ）. The axial images and combined images were superior to MPR images in accuracy, the results were statistically different （ P 〈 0. 05）. In the evaluation of the thyroid cartilage, the three group findings were 94. 3% ,77. 1% 和 97. 1% in accuracy respectively, the results were statistically different （ P 〈 0. 05 ）. The axial images and combined images were superior to MPR images in accuracy, the results were statistically different （P 〈 0. 05 ）. In the evaluation of the epiglottis, aryepiglottic fold, ventricular fold, vocal cord, preepiglottic space, pyriform sinus, arytenoid cartilage and extralaryngeal spread, the results had no statistically difference among the three groups （P 〉 0. 05 ）. The combined images were superior to the axial images and the MPR images in sensitivity, specificity and accuracy of the lesion extent. Conclusion The axial images could show the shape, size, extension of the tumor and the lymphadenopathy, MPR images displayed the shape, size and extension roundly and directly, they were the supplement for the axial images. Axial images combined with MPR could improve the accuracy in the diagnoses of laryngeal carcinoma.