多层螺旋CT及其图像后处理技术在咽喉部肿瘤诊断中的应用

Application of multi-slice helical CT and image post-progressing in larynx and hypopharynx carcinoma

目的探讨螺旋CT及后处理技术对喉癌及下咽癌的临床诊断价值。方法对经手术病理、纤维喉镜证实喉癌及下咽癌患者45例,术前行CT扫描并进行多平面重建(multi-planar reconstruction,MPR)、计算机体层摄影仿真内镜检查法(computed tomography virtual endoscopy,CTVE)、容积再现技术(volume rendering technique,VRT)成像,以术中所见、纤维喉镜为对照,比较CT横断面及各种后处理技术对喉癌及下咽癌的诊断价值。结果CT横断面图像、MPR图像显示肿瘤及侵及范围与手术结果差异无统计学意义(P>0.05);CTVE显示喉腔及气道黏膜病变与纤维喉镜差异无统计学意义(Q=0.59,P>0.05),但显示咽喉部黏膜扁平型病变或黏膜下浸润不及纤维喉镜;纤维喉镜显示喉腔及气道黏膜病变优于VRT图像(Q=5.60,P<0.01)。结论螺旋CT横断面、MPR、CTVE和VRT相结合可明显提高对咽喉部肿瘤的诊断价值。

Objective To evaluate the clinical application of helical CT in larynx and hypopharynx carcinoma. Methods 45 patients with larynx or hypopharynx carcinoma were confirmed by fibrolaryngoscope and histopathology. All were subjected to CT scanning, MPR, CTVE, and transparent 3D VRT images were reconstructed before the operations. Results There were no sig- nificantly differences between transection image and histopathology （ Q = 0.68, P 〉 0.05）, between MPR and histopathology （ Q = 0.34, P 〉 0.05）, and between ClUE and fibro laryngoscope（ Q = 0.59, P 〉 0.05 ）in diagnosis of larynx and hypopharynx carcinoma. However, the fibrolaryngoscope was better than CTVE or VRT in demonstrating membrane carcinoma of the larynx and hypopharynx（ Q = 5.60, P 〈 0.01）. Conclusion Transection image in combination with MPR, CTVE, and VRT images could improve the diagnostic value of multi-slice helical CT in larynx and hypophatynx carcinoma.