Castelijns J A, van den Brekel M W, Smit E M, Tobi H, van Wagtendonk F W, Golding R P, Venema H W, van Schaik C, Snow G B
Department of Radiology, Free University Hospital, Amsterdam, The Netherlands.
Radiology. 1995 Sep;196(3):735-9. doi: 10.1148/radiology.196.3.7644637.
To determine the predictive value of several clinical and radiologic parameters for recurrence of laryngeal cancer.
Eighty previously untreated patients underwent magnetic resonance (MR) imaging before radiation therapy with curative intent. Tumor volume was calculated from T1-weighted MR images. Cartilage was considered invaded by pathologic tissue if it had intermediate signal intensity on T1-weighted spin-echo (SE) MR images and high signal intensity on T2-weighted SE MR images. The minimum follow-up was 2 years.
Parameters such as age, sex, histopathologic findings, and invasion of the vocal muscle or pre-epiglottic space were not significantly correlated with tumor recurrence. Logistic regression analysis showed three relevant contributors: cord mobility, as judged clinically, and tumor volume and, more significantly, cartilage invasion, as seen at MR imaging.
For untreated laryngeal cancer, MR imaging findings of tumor volume and cartilage invasion allow better patient selection for either radiation therapy or surgery. MR imaging is mandatory for T staging of laryngeal cancer.
确定几种临床和放射学参数对喉癌复发的预测价值。
80例未经治疗的患者在进行根治性放射治疗前接受了磁共振(MR)成像检查。肿瘤体积根据T1加权MR图像计算。如果软骨在T1加权自旋回波(SE)MR图像上呈中等信号强度,在T2加权SE MR图像上呈高信号强度,则认为有病理组织侵犯。最短随访时间为2年。
年龄、性别、组织病理学表现以及声带肌或会厌前间隙侵犯等参数与肿瘤复发无显著相关性。逻辑回归分析显示有三个相关因素:临床判断的声带活动度、肿瘤体积,更重要的是MR成像显示的软骨侵犯。
对于未经治疗的喉癌,肿瘤体积和软骨侵犯的MR成像表现有助于更好地选择放疗或手术的患者。MR成像对于喉癌的T分期是必不可少的。