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目的 探讨螺旋CT仿真喉镜 (CTVL)、三维重建 ( 3D)和多平面重组 (MPR)在喉及下咽癌的临床应用价值。方法 2 2例喉及下咽癌患者进行轴位螺旋CT扫描 ,同时做MPR、3D和CTVL成像 ,并与纤维喉镜、手术所见对照分析。结果 螺旋CT轴位结合MPR图像对术前肿瘤分期和诊断颈部淋巴结转移的准确性都是 95% ;2 3%的病例MPR显示肿瘤侵犯的范围优于轴位 ,3D重建可立体显示肿瘤的侵犯范围及其与血管、气管的关系 ;头端CTVL显示喉及下咽部腔内病变的部位、大小及侵犯范围与纤维喉镜所见相似 ,3例从足侧观察肿瘤与声带和前联合的关系弥补了纤维喉镜的不足。结论 螺旋CT轴位图像能很好地显示喉及下咽癌的部位、大小及其侵犯范围 ,MPR和 3D重建是轴位图像的有力补充 ,CTVL能清楚显示喉及下咽部的腔内结构 ,是纤维喉镜的很好补充手段。
Objective To investigate the clinical value of spiral CT virtual laryngoscope (CTVL), three-dimensional reconstruction (3D) and multiplanar reconstruction (MPR) in laryngeal and hypopharyngeal carcinoma. Methods Twenty-two patients with laryngeal and hypopharyngeal carcinoma underwent axial helical CT scan and performed MPR, 3D and CTVL imaging simultaneously. Results The accuracy of preoperative tumor staging and diagnosis of cervical lymph node metastasis by spiral CT and MPR images was 95%. In 23% of the cases, MPR showed that the extent of tumor invasion was superior to that of axial and 3D reconstruction could display tumor The extent of invasion and the relationship with the vascular and trachea; CTVL showed the lesion location, size and extent of invasion in the larynx and hypopharynx were similar to those seen with the fibrolaryngoscope. Three cases were observed from the foot side of the tumor with the vocal cords and anterior commissure The relationship makes up for the lack of fiber laryngoscope. Conclusion Spiral CT axial images can well show the location, size and extent of invasion of laryngeal and hypopharyngeal carcinoma. MPR and 3D reconstruction are powerful complement to axial images. CTVL can clearly show the intraluminal structures of larynx and hypopharynx , Is a good fiber laryngoscope complementary means.