螺旋CT检查在喉癌及喉咽癌颈部淋巴结转移中的诊断价值

The Diagnostic Value of Spiral CT Scan in Cervical Lymph Node Metastasis of Laryngeal Carcinoma and Hypopharyngeal Carcinoma

目的探讨螺旋CT扫描在喉癌及喉咽癌颈部淋巴结转移中的应用价值。方法对2014年1月至2015年1月我院收治的喉癌及喉咽癌患者46例进行回顾分析。所有患者均经术后病理实验证实为喉癌与喉咽癌,明确发生颈部淋巴结转移患者21例,术前所有患者均行螺旋CT检查,比较病理结果与螺旋CT对喉癌及喉咽癌的病理分期及颈部淋巴结转移的诊断结果。结果 CT对喉癌及喉咽癌的术前T分期结果与术后病理T分期结果比较无显著差异,P>0.05,不具有统计学意义;CT对颈部淋巴结转移检出率与术后病理结果比较无显著差异,P>0.05,21例淋巴结转移患者螺旋CT增强显示均可见淋巴结不同程度增大,18例患者淋巴结相互融合成团并呈现不规则、分叶状,淋巴结界限不清并与周围组织有粘连,中心可出现低密度坏死区或环样强化。结论术前螺旋CT检查可准确评估患者病理分期,并且对颈部淋巴结转移的检出率较高,可用于指导临床手术治疗及术后康复方案的选择,具有应用及推广价值。

Objective To explore the application value of spiral CT scan in cervical lymph node metastasis of laryngeal carcinoma and hypopharyngeal carcinoma. Methods Randomly selected 46 consecutive hospitalized patients with laryngeal carcinoma and hypopharyngeal carcinoma between January 2014 and January 2015 as the research object. All the patients were diagnosed as laryngeal carcinoma and hypopharyngeal carcinoma by pathological experiments after operations. 21 patients were diagnosed as cervical lymph node metastasis. All the patients were examined by spiral CT before operations. And compared the pathological results with the spiral CT＇ s pathological stage of laryngeal carcinoma and hypopharyngeal carcinoma and diagnosis of cervical lymph node metastasis. Results In CT, there was little difference between the result of preoperative T staging and postoperative T staging of laryngeal carcinoma and hypopharyngeal carcinoma. （ P 〉 0.05 ） And it was not statistically significant. There was little difference between the detection rates of cervical lymph node metastasis in CT and the postoperative pathological results. （P 〉 0. 05 ） In enhanced spiral CT, we could see the enlargement of lymph nodes of 21 cases with cervical lymph node metastasis in different levels. And the lymph nodes in 18 cases merged into groups irregularly and lobulatedly. The boundaries of lymph nodes were blurred and adhesive with the surrounding tissues. Besides, the central parts of the lymph nodes were low density necrosis areas or ringlike intensify. Conclusion Spiral CT examination before the operation can accurately evaluate the pathological staging of patients and also have a high detection rate of the lymph node metastasis, which has values on clinical application and promotion.