MRI在喉癌诊断、分期及术后随访中的价值

The value of MRI in the diagnosis,staging and postoperative follow-up of laryngeal cancer

目的:探讨MRI在喉癌诊断、分期及术后随访中的价值。方法:回顾性分析25例经病理证实的喉癌的术前及术后随访的MRI表现。13例先行放射治疗,6周后行手术切除,12例喉癌术后3～8周开始放疗。所有患者手术前或放疗前均行MR扫描,并在随访过程中行MR扫描。结果:治疗前喉癌MRI表现为声带增厚、喉内软组织肿块、喉深部间隙狭窄等。MRI对各期喉癌的准确率分别是T1:92.3%,T2:71.4%,T3:50%,T4:100%。MRI分期总准确率为80.0%。13例术前放疗肿瘤缩小10例,消失3例。12例术后放疗病灶MRI表现为局部不同程度水肿,9例3～10个月后水肿消退,1例表现为慢性水肿,2例为炎性肉芽肿。结论:喉癌的MRI表现有一定的特征性,MRI在喉癌的术前T分期中有重要价值。在术后MRI随访能鉴别喉癌放疗后出现的反应性水肿、慢性淋巴水肿、喉狭窄、原发肿瘤的改变和复发性喉癌。

Objective To investigate the value of MRI in the diagnosis, staging and postoperative follow-up in laryngeal cancer. Methods The preoperative and postoperative follow-up MRI images of 25 cases of laryngeal cancers, which were confirmed by pathology, were retrospectively analyzed. 13 cases received surgical resection 6 weeks after radiation therapy, 12 cases received radiotherapy 3 - 8 weeks after surgical resection. All the cases received MRI before the surgery or radiotherapy and in the follow-up process. Results Before the treatment, MRI showed vocal cord thickening, soft tissue mass in the throat and throat deep space narrowing. The accuracies of MRI in stage T1, T2, T3 and T4 of laryngeal cancer were 92.3%, 71.4%, 50% and 100%. The Overall accuracy of MRI staging was 80.0%. After the treatment, the rumor was shrunk in 10 cases and was disappeared in 3 cases among the 13 cases. And among the 12 cases, the MRI showed edema with different degree and disappeared gradually in 3 - 10 months, the affected range of tumor was also reduced or disappeared, 1 case was chronic edema, and 2 cases were inflammatory edema. Conclusion The MRI findings of laryngeal cancer had certain characteristics, MRI was of great value in the T staging of laryngeal carcinoma. In the postoperative following-up, MRI can observe the reactive edema, chronic lymphatic edema, laryngeal stenosis, shrinking of the primary tumor and the recurrent laryngeal carcinoma.