From the Department of Imaging, University College London Hospitals, London, England (T.B., S.M.); Department of Otorhinolaryngology, Royal National Throat, Nose and Ear Hospital, 330 Gray's Inn Road, Kings Cross, London WC1X 8DA, England (V.M.T.); and Serviço de Radiologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal (M.H.).
Radiographics. 2020 May-Jun;40(3):775-790. doi: 10.1148/rg.2020190160.
Although US is one of the most used modalities for head and neck imaging, its use in the diagnosis of laryngeal abnormalities is much less widespread. The standard assessment of laryngeal abnormalities currently involves direct laryngoscopy and cross-sectional imaging (either CT or MRI) but rarely US. US is readily available, noninvasive, and radiation free, and it allows real-time imaging (with video for dynamic assessment), higher resolution than that of cross-sectional imaging, and the performance of targeted fine needle aspiration cytology or biopsy. This modality, particularly with the advent of high-resolution US, has been found to be at least comparable to CT or MRI for diagnosis of malignant lesions and benign abnormalities such as vocal nodules, polyps, cysts, and Reinke edema. Furthermore, it has been found to be more sensitive for diagnosis of abnormalities such as small glottic tumors, and its dynamic capability can be used to identify functional abnormalities such as vocal cord palsy. The authors outline the technique of laryngeal US, which includes strategies to avoid calcified laryngeal cartilage by imaging through the thyrohyoid and cricothyroid membranes with a five-sweep strategy supplemented by cine film of the technique. They also provide US images of common laryngeal abnormalities such as tumors with and without extralaryngeal extension; vallecular, thyroglossal, and vocal cord cysts; laryngeal mucoceles; and vocal cord palsy. RSNA, 2020.
尽管美国是最常用于头颈部成像的模态之一，但它在诊断喉部异常方面的应用要广泛得多。目前，喉部异常的标准评估包括直接喉镜检查和横断面成像（CT 或 MRI），但很少使用超声。超声具有易于获得、非侵入性和无辐射的特点，允许实时成像（动态评估时带有视频），其分辨率高于横断面成像，并且能够进行靶向细针抽吸细胞学检查或活检。这种模态，特别是随着高分辨率超声的出现，已经被发现至少与 CT 或 MRI 一样可用于诊断恶性病变和良性异常，如声带小结、息肉、囊肿和 Reinke 水肿。此外，它在诊断小声带肿瘤等异常方面更为敏感，其动态能力可用于识别声带麻痹等功能异常。作者概述了喉部超声技术，包括通过甲状舌骨膜和环状软骨膜进行五次扫描策略，同时辅以技术的电影，以避免甲状软骨钙化的策略。他们还提供了常见喉部异常的超声图像，如伴有或不伴有喉外延伸的肿瘤、会厌、甲状舌管和声带囊肿、喉黏液囊肿和声带麻痹。RSNA，2020 年。
