超声造影在喉癌诊断中的应用

Application of contrast enhanced ultrasound in the diagnosis of laryngeal cancer

目的探讨超声造影(CEUS)诊断喉癌及术前T分期的价值。方法2017年4月至2020年5月广西壮族自治区人民医院病理确诊的喉癌患者43例,术前分别行常规超声、CEUS及增强CT(CECT)检查。观察记录喉癌的超声造影特征,对比评价CEUS、常规超声及CECT对喉癌术前T分期及喉软骨侵犯的判断准确性。结果常规超声、CEUS与CECT对喉癌肿瘤检出率差异无统计学意义(P>0.05)。喉癌的超声造影增强模式以高增强、分布不均匀、快速增强、快速消退为主要特点。常规超声、CEUS及CECT对喉癌术前T分期的准确度分别81.4%、88.4%及90.7%,差异无统计学意义(P>0.05)。CEUS较常规超声可更清晰地显示喉软骨连续完整性,CEUS评价喉软骨侵犯的灵敏度、特异度及准确度高于常规超声。结论超声造影可无创性准确评估喉癌术前T分期及喉软骨侵犯。

Objective To investigate the value of contrast enhanced ultrasound(CEUS)in the diagnosis of laryngeal cancer and preoperative T-staging.Methods A total of forty-three patients with pathologically confirmed laryngeal cancer were collected and underwent conventional ultrasound,CEUS and enhanced CT(CECT)preoperatively,respectively.The ultrasonographic features of laryngeal cancer were observed and recorded,and the accuracy of CEUS,conventional ultrasound and CECT on preoperative T-staging and laryngeal cartilage invasion of laryngeal cancer were compared and evaluated.Results There was no statistically significant difference in the tumor detection rate of laryngeal cancer between conventional ultrasound,CEUS and CECT(P>0.05).The ultrasonographic enhancement pattern of laryngeal cancer was mainly characterized by high enhancement,uneven distribution,rapid enhancement and rapid fading.The accuracy of preoperative T-staging of laryngeal cancer by conventional ultrasound,CEUS and CECT was 81.4%,88.4%and 90.7%respectively,and there was no statistically significant difference(P>0.05).CEUS could show the continuous integrity of laryngeal cartilage more clearly than conventional ultrasound,and the sensitivity,specificity and accuracy of CEUS in evaluating laryngeal cartilage invasion were higher than those of conventional ultrasound.Conclusion CEUS can be used to assess preoperative T-stage and laryngeal cartilage invasion of laryngeal cancer in a non-invasive and accurate manner.