[The value of multislice spiral CT in the diagnosis and staging of laryngeal carcinoma].

OBJECTIVE

To our knowledge, no date are available comparing the impact of multislice spiral CT, and multiplanar reconstruction (MPR) and Virtual endoscopy (VE) on pretherapeutic staging accuracy. The purpose of our study was to determine which imaging should be used as an adjunct to other clinical examinations in the pretherapeutic diagnosis and staging of laryngeal carcinoma.

METHOD

Thirty-two patients with laryngeal carcinoma who were treated surgically, were prospectively underwent by contrast-enhanced multislice spiral CT, and MPR and VE were subsequently done. CT slice thickness 5 mm, table feed was 5 mm, and 100 ml of intravenous contrast material was administered at a flow of 3.0 ml/s. Two radiologists evaluated axial image and the combined image, the results were studied in a blind way. UICCTNM stages were determined by the axial image findings and the combined image findings of axial image, MPR, and VE, were compared and correlated with postoperative pathology and microlaryngoscopy.

RESULT

In the evaluation of the neoplastic invasion of ventricular fold, vocal cord, the anterior commissure, subglottic region,paraglottic space (PGS), pre-epiglottic space (PES), thyroid cartilage, and tissue beyond the larynx, the combined images were better than axial images in accuracy (98.3% vs 91.3%, P < 0.01); The accuracy of the combined images staging was 81.3% and the accuracy of axial image staging was 93.8%, the difference was not statistically significant (P > 0.05).

CONCLUSION

Axial image combined with subsequent MPR and VE could improve the diagnosis in the evaluation of the neoplastic invasion, neither axial image or the combined images could significantly improve pretherapeutic staging of laryngeal carcinoma.