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目的 :研究高频超声波内窥镜图像技术在喉病变 ,特别是喉癌诊断中的应用。方法 :用可屈的小内径 (8-1 0F)高频 (1 0 -2 0MHz)内窥镜式超声探头 ,对 45例患者行喉腔内无创伤检查。在频率 1 0MHz最大探及 3cm ,在 2 0MHz最大探及 1 .5cm。超声图上 ,准确测量出肿瘤垂直直径大小及位置。结果 :其中探查到3 2例喉癌 ,与周围组织相比 ,呈现出典型的反射矩阵波。在显微喉镜检查中 ,借助高频超声可探查到T1 声带癌 (n=1 3 ) ,最小瘤体直径约 3mm的浸润癌。但 1 3例中有 6例探查不到肿瘤 (假阴性 ) ,假阳性结果尚未发现。T2 -T3喉癌 (n =1 2 )较易诊断 ,在声门上区和声门下区肿瘤较周围组织显示低回声区 ;T4 肿瘤 (n =7)侵犯甲状软骨可在超声图上较易显出 ,肿瘤的低回声区与甲状软骨内膜的高回声区有明显的反差 ;另外探及喉良性病变 1 3例。结论 :运用内窥镜式高频超声可在显微镜检查中对喉病变 ,特别是喉肿瘤的大小及相应浸润范围 ,做出更为准确的诊断 ,对保留喉功能的喉癌术式选择有指导意义
Objective: To study the application of high-frequency ultrasound endoscopic imaging in the diagnosis of laryngeal diseases, especially laryngeal cancer. Methods: Fifty-five patients underwent intrathoracic noninvasive examination with a flexible small diameter (8-1 0F) high frequency (100-2 0MHz) endoscopic ultrasound probe. In the frequency 1 0MHz maximum exploration and 3cm, 2OMHz maximum exploration and 1.5cm. On the ultrasound image, the vertical diameter and location of the tumor were accurately measured. Results: 32 cases of laryngeal cancer were detected, showing a typical reflection matrix wave compared with the surrounding tissues. In the microlaryngoscope examination, with the help of high-frequency ultrasound to detect T1 vocal cord cancer (n = 13), the smallest tumor diameter of about 3mm invasive cancer. However, 6 out of 13 cases were undetectable (false negative) and false positive results were not found. T2-T3 laryngeal carcinoma (n = 12) was easier to diagnose, and tumors in the supraglottic and subglottic tumors showed hypoechoicity than the surrounding tissues; T4 tumors (n = 7) were more likely to be infiltrated with thyroid cartilage on the ultrasound images Shows that the tumor hypoechoic area and thyroid cartilage in the hyperechoic area significantly contrast; another exploration and throat benign lesions in 13 cases. Conclusion: Using endoscopic high-frequency ultrasound in the microscopic examination of laryngeal lesions, especially the size of the laryngeal tumor and the corresponding extent of infiltration, to make a more accurate diagnosis of laryngeal laryngeal cancer surgery options to guide the choice of guidance significance