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目的探讨螺旋CT及后处理技术对喉癌及下咽癌的临床诊断价值。方法对经手术病理、纤维喉镜证实喉癌及下咽癌患者45例,术前行CT扫描并进行多平面重建(multi-planar reconstruction,MPR)、计算机体层摄影仿真内镜检查法(computed tomography virtual endoscopy,CTVE)、容积再现技术(volume rendering technique,VRT)成像,以术中所见、纤维喉镜为对照,比较CT横断面及各种后处理技术对喉癌及下咽癌的诊断价值。结果CT横断面图像、MPR图像显示肿瘤及侵及范围与手术结果差异无统计学意义(P>0.05);CTVE显示喉腔及气道黏膜病变与纤维喉镜差异无统计学意义(Q=0.59,P>0.05),但显示咽喉部黏膜扁平型病变或黏膜下浸润不及纤维喉镜;纤维喉镜显示喉腔及气道黏膜病变优于VRT图像(Q=5.60,P<0.01)。结论螺旋CT横断面、MPR、CTVE和VRT相结合可明显提高对咽喉部肿瘤的诊断价值。
Objective To investigate the clinical value of spiral CT and post-processing in the diagnosis of laryngeal and hypopharyngeal carcinoma. Methods Forty-five patients with laryngeal and hypopharyngeal carcinoma confirmed by pathology and fibrolaryngoscope were enrolled in this study. Preoperative CT scan was performed with multi-planar reconstruction (MPR), computed tomography endoscopy (computed tomography) tomography virtual endoscopy (CTVE) and volume rendering technique (VRT) were performed in this study. The diagnosis of laryngeal carcinoma and hypopharyngeal carcinoma were compared between CT scan and fiber laryngoscope. value. Results There was no significant difference in CT and MPR between tumor and extent of invasion and surgical outcome (P> 0.05). CTVE showed no significant difference between laryngeal cavity and airway mucosa lesions and fibrolaryngoscope (Q = 0.59 , P> 0.05). However, the laryngopharyngeal mucosa flat lesions and submucosal infiltration were inferior to those of fiber laryngoscope. The laryngoscopy and airway mucosal lesions were better than VRT images (Q = 5.60, P <0.01). Conclusion The combination of spiral CT, MPR, CTVE and VRT can significantly improve the diagnostic value of thoracic tumors.