Leuwer R M, Westhofen M, Schade G
ENT-Clinic, Hamburg University Medical School (Eppendorf University Hospital), Germany.
Am J Otolaryngol. 1997 Jul-Aug;18(4):254-7. doi: 10.1016/s0196-0709(97)90005-3.
The aim of the present study was to demonstrate the rating of low-flow color duplex echography in the staging of head and neck cancer.
Fifty-two patients with squamous cell carcinoma of the oral cavity, the oropharynx, and hypopharynx were examined. A Siemens Q 2000 duplex scan with 7.5 MHz-linear array and wedge (Siemens Medizintechnik, Siemens Medical Systems, Erlangen, Germany) was used. Gray scale imaging as well as color duplex scan with Doppler spectrum measurement were performed for each patient.
Only 5 of 52 primary tumors could not be detected using echography (sensitivity: 90%). Tumor size of one carcinoma, a recurrent tumor of the laryngeal sinus, was overestimated (predictive value: 96%). The carcinomas and their metastases were poorly vascularized. Only 10 of 52 primary tumors showed central vascularization. The mean systolic flow rate in these vessels was 40 cm/s. In 17 patients, imaging of peripheral tumor vessels improved estimation of tumor borders. Imaging of irregular central tumor vessels in metastatic lymphatic nodes yielded important information for N staging.
Low-flow color duplex echography is a new high resolution, noninvasive imaging technique that offers important additional information for preoperative head and neck tumor staging. Thus, it should be recommended for routine application in ENT-oncology.
本研究旨在论证低流量彩色双功超声检查在头颈部癌分期中的分级情况。
对52例口腔、口咽和下咽鳞状细胞癌患者进行了检查。使用了西门子Q 2000双功扫描仪，配备7.5兆赫线性阵列和楔形探头（德国埃尔兰根西门子医疗技术公司，西门子医疗系统公司）。对每位患者进行了灰阶成像以及带有多普勒频谱测量的彩色双功扫描。
52例原发性肿瘤中仅5例无法通过超声检查检测到（敏感性：90%）。1例喉窦复发性癌的肿瘤大小被高估（预测值：96%）。癌及其转移灶血供较差。52例原发性肿瘤中仅10例显示中央血供。这些血管中的平均收缩血流速度为40厘米/秒。在17例患者中，外周肿瘤血管成像改善了对肿瘤边界的估计。转移性淋巴结中不规则中央肿瘤血管的成像为N分期提供了重要信息。
低流量彩色双功超声检查是一种新的高分辨率、非侵入性成像技术，为术前头颈部肿瘤分期提供了重要的额外信息。因此，应推荐其在耳鼻喉肿瘤学中常规应用。
