Silver Jennifer A, Lahijanian Zubin, Kay-Rivest Emily, Marquez Juan C, Young Jonathan, Chagnon Francoise, Torres Carlos, Kost Karen M
Department of Otolaryngology-Head and Neck surgery, Royal Victoria Hospital, Montreal, Quebec, Canada.
Department of Radiology, Royal Victoria Hospital, Montreal, Quebec, Canada.
J Voice. 2023 Aug 16. doi: 10.1016/j.jvoice.2023.06.020.
OBJECTIVE/HYPOTHESIS: To review the imaging findings of laryngeal amyloidosis and to identify radiological findings suggestive of this disease.
Retrospective case series.
A retrospective chart review of patients with pathologically confirmed laryngeal amyloidosis was performed from 2009 to 2022. Clinical and demographic factors were collected. A fellowship-trained head and neck radiologist reviewed all computed tomography (CT) scans and magnetic resonance imaging (MRI) findings within this cohort.
12 patients were identified and a total of 36 imaging studies analyzed. Localized amyloidosis was found in the supraglottic region (n = 6), glottic region (n = 7), and subglottic region (n = 5); six patients had disease spanning two subsites. The most common finding on the CT scan was a homogeneous and well-defined submucosal soft tissue mass. Punctate calcifications were present in three cases. The presence of contrast enhancement was identified in the majority of patients who underwent MRI (4/5). MRI showed consistent signal intensity, hypointense, or isointense on both T1-weighted and T2-weighted images. Diffusion-weighted sequences were obtained in every patient and did not demonstrate diffusion restriction.
This is the largest series searching for unifying imaging characteristics of laryngeal amyloidosis. This research suggests that characteristics from CT and MR provide both similar and unique features of laryngeal amyloidosis on imaging. Both modalities identify a submucosal mass. CT is the preferred modality to demonstrate punctate calcifications, while MRI identifies enhancement and altered signal characteristics. The main benefit of serial imaging is the correlation with patient symptoms, identification of the extent of disease, and assisting in delineating appropriate timing for surgery.
目的/假设：回顾喉淀粉样变性的影像学表现，并确定提示该病的放射学表现。
回顾性病例系列研究。
对2009年至2022年病理确诊为喉淀粉样变性的患者进行回顾性病历审查。收集临床和人口统计学因素。一位接受过专科培训的头颈放射科医生审查了该队列中的所有计算机断层扫描（CT）和磁共振成像（MRI）结果。
共识别出12例患者，分析了36项影像学研究。在声门上区（n = 6）、声门区（n = 7）和声门下区（n = 5）发现局限性淀粉样变性；6例患者的病变跨越两个亚部位。CT扫描最常见的表现是均匀且边界清晰的黏膜下软组织肿块。3例出现点状钙化。大多数接受MRI检查的患者（4/5）有强化表现。MRI在T1加权和T2加权图像上均显示一致的信号强度，呈低信号或等信号。所有患者均进行了扩散加权序列检查，未显示扩散受限。
这是寻找喉淀粉样变性统一影像学特征的最大系列研究。该研究表明，CT和MR的特征在影像学上提供了喉淀粉样变性的相似和独特特征。两种检查方法均能识别黏膜下肿块。CT是显示点状钙化的首选检查方法，而MRI可识别强化及信号特征改变。系列影像学检查的主要益处在于与患者症状的相关性、疾病范围的确定以及协助确定合适的手术时机。
