Lee Kimberly J, Abemayor Elliot, Sayre James, Bhuta Sunita, Kirsch Claudia
Department of Surgery, Division of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Otolaryngol Head Neck Surg. 2008 Aug;139(2):275-80. doi: 10.1016/j.otohns.2008.04.026.
Perineural invasion in head and neck cancers has important prognostic implications, and even if clinically silent, can be radiographically evident. This study analyzed the frequency of preoperative diagnosis, radiographic features, and importance of the preoperative diagnosis in treatment planning.
Radiographic studies of 38 patients with histopathologically proven perineural spread from head and neck cancer were retrospectively reviewed and compared with preoperative reports.
The percent agreement with pathology, kappa values, and 95 percent confidence intervals were determined for relevant nerves. Salient radiographic findings were compared with the contralateral normal side.
Preoperative agreement was less than 10 percent for all nerves, and retrospectively was 56 percent for the trigeminal nerve and 40 percent for the facial nerve. Radiographic features included neural thickening and enhancement, and foraminal widening.
Cancers of the head and neck can spread perineurally. Preoperative radiographic determination, although underreported, is imperative, because diagnosis impacts management and prognosis.
头颈部癌症中的神经周围侵犯具有重要的预后意义，即使临床上无症状，在影像学上也可能表现明显。本研究分析了术前诊断的频率、影像学特征以及术前诊断在治疗计划中的重要性。
回顾性分析38例经组织病理学证实有头颈部癌症神经周围扩散患者的影像学研究，并与术前报告进行比较。
确定相关神经与病理的一致百分比、kappa值和95%置信区间。将显著的影像学表现与对侧正常侧进行比较。
所有神经术前诊断的一致性均低于10%，回顾性分析显示三叉神经为56%，面神经为40%。影像学特征包括神经增粗、强化和孔扩大。
头颈部癌症可沿神经周围扩散。术前影像学诊断虽然报告较少，但至关重要，因为诊断会影响治疗和预后。
