CT扫描在声门上癌的临床应用价值

Evaluation of CT in the study of supraglottic carcinoma

目的 :探讨CT对声门上癌的诊断价值及其在术前分期中的作用。方法 :回顾性分析 35例经病理证实的声门上癌的CT表现 ,根据CT征象对肿瘤进行分期并与手术病理对照分析。 5例患者作了CT仿真喉镜 (CTVL)成像。结果 :肿瘤呈局部软组织增厚或团块状肿块 ,形态不规则 ,密度较均匀 ,增强后轻度强化 ;本组CT术前肿瘤分期 (T)和诊断颈部淋巴结转移的准确性分别是 87%和 90 % ,评价周围结构受侵的准确性为 83%～ 10 0 %。CTVL能很好地显示肿瘤的部位、大小及侵犯范围 ,并可从足侧观察狭窄远端及声门下区的情况。结论 :CT能很好地显示声门上癌的侵犯范围及有无颈部淋巴结转移 ,但对评价声带受侵和诊断正常大小的淋巴结转移尚有一定的局限性。CTVL是纤维喉镜的很好补充手段。

Objective:To evaluate CT in diagnosis and preoperative staging of the supraglottic carcinoma.Methods:CT features in 35 cases with supraglottic carcinoma confirmed by pathology were analyzed retrospectively.The tumor staging with CT-pathologic correlative study was performed,and CT virtual laryngoscopy(CTVL)was done in 5 cases.Results:The tumors showed as a thickness or bulky mass of the local supraglottic structure with irregular margin,homogeneous attenuation and slight enhancement.In our study,the accuracy of the preoperative staging and metastatic lymph nodes was 87% and 90% respectively,and the accuracy for involoved surrounding structures ranged from 83% to 100%.CTVL could clearly demonstrate the location,size and extension of tumors,and by caudocranial approach,CTVL revealed the distal portion of tumor and the structure of subglottic region.Conclusion:CT can reliably show the extension of the supraglottic carcinoma and detect metastatic lymph nodes,but it has some limitations for evaluating vocal cord invasion and metastatic lymph nodes with normal size.CTVL is a good complementary method of laryngoscopy.