Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA.
Neuroimaging Clin N Am. 2013 Feb;23(1):147-66. doi: 10.1016/j.nic.2012.08.011.
Lymph nodes status is an important predictor of prognosis in head and neck squamous cell carcinoma, making accurate staging critical. The physical examination of the neck is highly inaccurate. CT, MR imaging, ultrasound (US), and positron emission tomography-CT (PET-CT) improve accuracy but have limitations. Size criteria, nodal shape and clustering, central necrosis, and findings of extracapsular spread and vascular encasement suggest metastatic involvement on CT and MR imaging. US features help differentiate benign from malignant nodes, aided by US-guided fine-needle aspiration for indeterminate cases. PET-CT is useful for staging the lymph nodes and detection of distant metastasis.
淋巴结状态是头颈部鳞状细胞癌预后的重要预测因素，因此准确分期至关重要。颈部体格检查的准确性非常低。CT、MR 成像、超声 (US) 和正电子发射断层扫描-CT (PET-CT) 提高了准确性，但也存在局限性。大小标准、淋巴结形状和聚集、中央坏死以及包膜外扩散和血管包埋的发现提示 CT 和 MR 成像上存在转移性累及。US 特征有助于区分良性和恶性淋巴结，对于不确定的病例，US 引导下的细针抽吸可提供帮助。PET-CT 可用于分期淋巴结和检测远处转移。
