论文部分内容阅读
目的:探讨将多层螺旋CT增强扫描的横断面图像、多平面重建图像(MPR)和仿真喉镜(VE)图像结合起来(联合图像)在喉癌术前诊断及TNM分期中的应用价值。方法:①32例拟诊喉癌患者行术前前瞻性多层螺旋CT增强扫描并行MPR和VE处理。②采用双盲法阅片,将单一横断面图像、MPR和VE联合图像分别作出CT诊断。③临床医师结合CT图像,分别进行国际抗癌协会(UICC)TNM临床分期。④完成喉癌手术,根据病理和电子喉镜确定病理学分期,将2种方法(横断面图像和MPR)的分期结果进行比较。结果:32例喉癌中,联合图像对评价室带、声带、前连合、声门下、声门旁间隙、会厌前间隙、甲状软骨、喉外结构受侵的准确率为98.3%,而横断面图像为91.3%,两者比较其准确率有统计学意义(χ2=20.624,P<0.01);横断面图像对喉癌分期的准确率为81.3%,联合图像为93.8%,两者比较差异无统计学意义(P>0.05)。结论:多层螺旋CT增强扫描的MPR和VE是横断面图像很好的补充,能够帮助提高喉癌诊断水平,横断面图像和联合图像对于喉癌术前临床分期无明显差别。
Objective: To explore the value of combined multi-slice CT (MPR) and virtual laryngoscope (VE) images in the preoperative diagnosis of laryngeal carcinoma and TNM staging. Methods: Thirty-two patients with suspected laryngeal cancer underwent prospective multi-slice spiral CT scan before MPR and VE. ② double-blind reading method, a single cross-sectional images, MPR and VE joint images were made CT diagnosis. ③ clinicians combined with CT images, respectively, for the international anti-cancer association (UICC) TNM clinical staging. ④ To complete the laryngeal cancer surgery, pathological staging was confirmed by pathology and electronic laryngoscope, and the staging results of two methods (cross-sectional images and MPR) were compared. Results: In 32 cases of laryngeal squamous cell carcinoma, the diagnostic accuracy of the combined images was 98.3% for the assessment of ventricular band, vocal cord, anterior commissure, subglottic glottic, glottic space, anterior epiglottic space, thyroid cartilage, The surface image was 91.3%. The accuracy of the two methods was statistically significant (χ2 = 20.624, P <0.01). The accuracy of the cross-sectional images was 81.3% and the joint image was 93.8% No statistical significance (P> 0.05). CONCLUSIONS: MPR and VE in MSCT scan are good complement to cross-sectional images and can help to improve the diagnosis of laryngeal cancer. There is no significant difference in the preoperative clinical stage of LSCC between the cross-sectional images and the joint images.