Monnet O, Cohen F, Lecorroller T, Vidal V, Jacquier A, Gaubert J Y, Bartoli J M, Moulin G
Service d'imagerie médicale adulte, Pr JM Bartoli et Pr G Moulin, Centre Hospitalier, Universitaire La Timone, 254 rue Saint Pierre, 13385 Marseille cedex 5, France.
J Radiol. 2008 Jul-Aug;89(7-8 Pt 2):1020-36. doi: 10.1016/s0221-0363(08)73905-2.
Imaging plays a chief role in the care and monitoring of patients in cervico-facial oncology. The radiologist must know the anatomy of different lymph nodes as well as signs of malignancy (hypertrophy, enhancement, necrosis, capsular rupture, etc.). CT is still the first-line examination because of its high reliability, its accessibility and its ability to make an assessment of the upper aero digestive ways at the same time. Ultrasound is very accuracy, and allows the realization of cytoponction, but does not provide a complete exploration of the neck. MRI does not appear to be indicated for the first intention, but the new rapid sequences (STIR, diffusion) seem interesting. The PET-CT is useful in post-therapeutic management of patients, and probably in the initial staging, but its accessibility is poor.
影像学在头颈部肿瘤患者的护理和监测中起着主要作用。放射科医生必须了解不同淋巴结的解剖结构以及恶性肿瘤的征象(肿大、强化、坏死、包膜破裂等)。由于CT具有高可靠性、易获得性以及能同时对上呼吸道和消化道进行评估的能力,它仍然是一线检查方法。超声检查准确性很高,还能进行细胞穿刺,但无法对颈部进行全面检查。MRI似乎不适合作为首选检查,但新的快速序列(短TI反转恢复序列、扩散加权成像)看起来很有意义。PET-CT在患者的治疗后管理中很有用,可能在初始分期中也有帮助,但它的可及性较差。