Conrad R, Pauleit D, Layer G, Kandyba J, Kohlbecher R, Hortling N, Baselides P, Schild H
Radiologische Universitätsklinik Bonn.
Rofo. 1999 Jul;171(1):15-9. doi: 10.1055/s-1999-9890.
To determine if scanning in the arterial phase improves detection of squamous cell carcinomas in the pharynx and larynx.
In a prospective clinical study 20 patients with a pharyngeal or laryngeal carcinoma were examined with by spiral CT. 80 ml lopromid were intravenously injected as a bolus with a rate of 3 ml/sec. Two consecutive spiral CT scans were performed with start-delay times of 20 and 70 seconds respectively. Delineation and contrast enhancement of tumours, cervical lymph nodes and vessels were evaluated. The radiodensities (HU) of tumors, lymph nodes vessels, pharyngeal wall and muscle were measured.
Comparing early and late start delay time scans tumor assessment in the early phase was better in 58%, less in 16% and equal in both scans in 26%. 82% of the pathologic lymph nodes had more peripheral enhancement than surrounding muscle tissue. During the arterial phase the measured radiodensities of the common carotid artery and jugular vein were significantly higher than in the second phase.
Contrast-enhanced special CT permits accurate morphologic assessment (size, infiltration) of pharyngeal and supraglottic laryngeal squamous cell carcinoma, while pathologic lymph nodes already have a sufficient contrast enhancement for the detection.
确定动脉期扫描是否能提高咽喉部鳞状细胞癌的检出率。
在一项前瞻性临床研究中，对20例咽喉癌患者进行螺旋CT检查。以3ml/秒的速率静脉推注80ml碘普罗胺。分别在开始延迟20秒和70秒时进行连续两次螺旋CT扫描。评估肿瘤、颈部淋巴结和血管的轮廓及对比增强情况。测量肿瘤、淋巴结、血管、咽壁和肌肉的放射密度（HU）。
比较早期和晚期开始延迟时间扫描，早期阶段肿瘤评估更好的占58%，更差的占16%，两者相等的占26%。82%的病理性淋巴结外周强化比周围肌肉组织更多。在动脉期，颈总动脉和颈静脉的测量放射密度明显高于第二阶段。
对比增强特殊CT可对咽喉部和声门上型喉鳞状细胞癌进行准确的形态学评估（大小、浸润情况），而病理性淋巴结已有足够的对比增强以便检测。
