Banko Bojan, Djukic Vojko, Milovanovic Jovica, Kovac Jelena, Novakovic Zorica, Maksimovic Ruzica
Center for Radiology and MRI, University Clinical Center of Serbia, Serbia.
Clinic for ENT and Maxillofacial Surgery, University Clinical Center of Serbia, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Auris Nasus Larynx. 2014 Oct;41(5):471-4. doi: 10.1016/j.anl.2014.02.008. Epub 2014 Mar 11.
The purpose of this study was to evaluate whether magnetic resonance (MR) imaging can accurately predict invasion of the preepiglottic and paraglottic space in patients with laryngeal carcinoma. Identification of these fat filling spaces is important for surgical treatment and prognosis.
The study was based on the prospective analysis of MRI images in a series of 40 patients (90% males), overall average age 60.1 ± 7.3 years, (49-70 years), with histopathologically diagnosed laryngeal squamous cell carcinoma. Unenhanced T2w, T2w FS, T1w, and contrast-enhanced T1w FS scans were analyzed for the presence of preepiglottic and paraglottic neoplastic invasion and were compared to postoperative histopathologic analysis.
In 28 patients (70%) the tumor was glottic and in 12 patients (30%) supraglottic. No statistical difference was found in the number of patients with positive MRI findings in comparison to postsurgical patohistology for infiltration of the preepiglottic space (23% vs 20%, respectively). Sensitivity for infiltration of preepiglottic space was 89% and specificity was 97%. However, infiltration of the paraglottic spaces was observed more frequently on MRI than on postsurgical patohistology analysis (60% vs 40%, respectively; p<0.05), with a sensitivity of 67% and a specificity 50%. According to MRI findings, 26 (65%) patients were classified as T3, 14 (35%) patients as T2 while according to histopathologic analysis of specimens after surgery, 19 patients were classified as T3 (48%) and 21 as T2 (52%).
MRI has been shown to be a reliable method for assessment of preepiglottic space while the diagnostic accuracy in patients with infiltration of the paraglottic space is limited.
本研究旨在评估磁共振成像（MR）能否准确预测喉癌患者会厌前间隙和声门旁间隙的受侵情况。识别这些脂肪填充间隙对手术治疗和预后至关重要。
本研究基于对40例患者（90%为男性）的MRI图像进行前瞻性分析，患者总体平均年龄60.1±7.3岁（49 - 70岁），均经组织病理学诊断为喉鳞状细胞癌。分析未增强T2加权像（T2w）、脂肪抑制T2加权像（T2w FS）、T1加权像（T1w）以及增强脂肪抑制T1加权像（T1w FS）扫描，观察会厌前间隙和声门旁间隙是否存在肿瘤侵犯，并与术后组织病理学分析结果进行比较。
28例患者（70%）肿瘤位于声门，12例患者（30%）肿瘤位于声门上。MRI检查发现会厌前间隙受侵阳性的患者数量与术后病理组织学检查结果相比，差异无统计学意义（分别为23%和20%）。会厌前间隙受侵的敏感性为89%，特异性为97%。然而，声门旁间隙受侵在MRI上的观察频率高于术后病理组织学分析（分别为60%和40%；p<0.05），敏感性为67%，特异性为50%。根据MRI表现，26例（65%）患者被归类为T3期，14例（35%）患者被归类为T2期；而根据术后标本的组织病理学分析，19例患者被归类为T3期（48%），21例患者被归类为T2期（52%）。
MRI已被证明是评估会厌前间隙的可靠方法，而对于声门旁间隙受侵患者的诊断准确性有限。
