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目的:探讨多层螺旋CT(MSCT)在下咽癌的诊断及手术中的应用价值,为耳鼻咽喉科医生手术提供理论依据。方法:回顾性分析45例经手术和病理证实下咽癌患者的MSCT和手术资料,所有MSCT扫描均采用增强扫描,扫描范围从硬腭至颈段食管。结果:45例下咽癌中位于梨状窝癌34例,环后区癌7例,下咽后壁癌4例。MSCT增强扫描显示下咽软组织影呈轻度或明显强化,梨状窝变窄或消失,咽后壁软组织增厚,喉软骨破坏、移位及侵犯食管入口、颈段食管和颈淋巴结转移。肿瘤可推移环状、杓状软骨向前移位及甲杓间隙和环甲关节间距增宽。根据MSCT制定的手术计划与实际基本一致,达91.1%。结论:MSCT能很好地显示下咽癌的部位、大小和侵犯范围及有无淋巴结转移,对制定手术计划具有指导意义。
Objective: To investigate the value of multi-slice spiral CT (MSCT) in the diagnosis and operation of hypopharyngeal carcinoma and provide theoretical basis for the operation of otolaryngology surgeons. Methods: The MSCT and surgical data of 45 patients with hypopharyngeal carcinoma confirmed by surgery and pathology were retrospectively analyzed. All MSCT scans were performed with enhanced scan ranging from the palate to the cervical esophagus. Results: In 45 cases of hypopharyngeal carcinoma, there were 34 cases of pyriform sinus cancer, 7 cases of posterior circumfocal carcinoma and 4 cases of hypopharyngeal wall cancer. MSCT enhanced scan showed hypopharyngeal soft tissue lesions were mild or significantly enhanced, narrow or disappear, pear throat, thickened pharyngeal soft tissue, laryngeal cartilage damage, transposition and invasion of the esophagus, cervical esophagus and cervical lymph node metastasis. Tumor can move around the ring, the arytenoid cartilage forward shift and nail arm gap and ring armor widened. According to the surgical plan developed by MSCT basically the same with the actual, up 91.1%. Conclusion: MSCT can show the location, size, extent of invasion, and lymph node metastasis of hypopharyngeal carcinoma well, which is instructive for the development of surgical plans.