Wenig B L, Ziffra K L, Mafee M F, Schild J A
University of Illinois, Chicago Medical Center, USA.
Otolaryngol Clin North Am. 1995 Jun;28(3):609-19.
Despite recent diagnostic advances, the laryngopharynx remains an area where accurate assessment of tumor size and extent is difficult. Computed tomography has proven helpful in delineating lesions in these areas, yet significant limitations exist. In an attempt to more accurately evaluate laryngopharyngeal neoplasms, MR imaging was performed in 25 consecutive patients with squamous cell carcinoma of the larynx and hypopharynx. Mr imaging was analyzed for its utility in clinical staging, assistance in selection of candidates for conservation, Laryngeal surgery, and ability to reliably predict cartilage invasion. MR imaging improved the accuracy of tumor staging by 40% and was valuable in the selection of candidates for conservation surgery. In addition, MR imaging was able to predict cartilage invasion in 6 of 6 patients with pathologic confirmation with a single false-positive case. MR imaging appears to be a reliable indicator of tumor size and location and should be judiciously incorporated into the staging and pretreatment planning of patients presenting with laryngopharyngeal malignancies.
尽管近年来诊断技术有所进步,但喉咽仍是一个难以准确评估肿瘤大小和范围的区域。计算机断层扫描已被证明有助于描绘这些区域的病变,但仍存在显著局限性。为了更准确地评估喉咽肿瘤,对25例连续性喉鳞状细胞癌和下咽癌患者进行了磁共振成像(MR成像)检查。分析了MR成像在临床分期、协助选择保留喉手术的候选患者以及可靠预测软骨侵犯方面的效用。MR成像将肿瘤分期的准确性提高了40%,在选择保留手术的候选患者方面具有重要价值。此外,在6例经病理证实的患者中,MR成像能够预测软骨侵犯,仅有1例假阳性病例。MR成像似乎是肿瘤大小和位置的可靠指标,应明智地纳入喉咽恶性肿瘤患者的分期和术前规划中。