MRI平扫和CT增强扫描在下咽癌诊断中的对比研究  

Comparison Study between MRI Plain Scan and CT Enhanced Scan in the Diagnosis of Patients with Hypopharyngeal Carcinoma

作　　者：张忻宇[1] 孔祥国[2] 王明广[1] 曹文[1] 黄勇华[1] 

机构地区：[1]青岛大学医学院附属医院放射科,青岛266003 [2]临沂市人民医院放射科,临沂276000

出　　处：《当代医学》2009年第20期127-131,共5页Contemporary Medicine

摘　　要：目的分析MRI平扫和螺旋CT增强扫描对下咽癌的诊断及周围解剖结构的显示情况,探讨MRI对下咽癌的诊断价值。方法对22例临床确诊下咽癌的病人分别进行MRI平扫、CT增强扫描,分析两种检查方法对下咽癌及其周围解剖结构的显示情况,对肿瘤进行分期并与临床手术病理结果进行对比。结果MRI平扫和CT增强扫描比较,MRI显示间隙(喉旁间隙、会厌前间隙)侵犯有18处,CT显示15处。MRI显示病变侵犯喉软骨10处,CT显示8处。MRI显示淋巴结肿大12处,CT显示10处。上述结果的P值均>0.05,差异没有统计学意义。15例手术显示侵犯环后区壁内脂肪层,其中MRI显示9例,CT显示3例(P<0.05),差异有统计学意义。MRI对肿瘤分期的准确性为90%,CT对肿瘤分期的准确性为82%(P>0.05),差异没有统计学意义。结论MRI对下咽癌的显示情况与CT增强扫描的显示情况类似,其分期与病理分期均无明显差别,说明两者在下咽癌的术前诊断中的作用类似;MRI在咽后壁脂肪层的显示方面要明显好于CT,但这些优势仍和临床病理有较大差距。Objective To evaluate the delineation of hypopharyngeal carcinoma and its surrounding anatomic structures in MRI plain scan and spiral CT enhanced scan and to investigate the diagnostic value of MRI to hypopharyngeal carcinoma. Methods Twenty-two patients with clinically definite hypopharyngeal carcinoma were examined with MRI plain scan and CT enhanced scan. The delineation and staging of the tumor with the two methods were analyzed and the comparison between MRI, CT and postoperative pathology was conducted. Rosults Compared with CT enhanced scan, MRI was similar to CT enhanced scan in the delineation of space （paralaryngeal space and preepiglottic space） （MRI n=18, CT n=15）, encroachment of laryngeal cartilages（MRI n=10, CT n=8）, metastatic lymph nodes （MRI n=12, CT n=10）（P〉 0.05）. MRI was superior to CT enhanced scan in the delineation of intramural fat planes of postcricoid region （ MRI n=9, CT n=3 ） （ P 〈 0.05）.The accuracy of the former was 90% and that of the latter was 82% in the tumor （T） staging respectively （P〉0.05）. Conclusion MRI plain scan was similar to spiral CT enhanced scan in the delineation of hypopharyngeal carcinoma and its surrounding anatomic structures, their T stages was similar to T stages of pathology. MRI was superior in the delineation of the adipose layer in paries of postcricoid area. In spite of superiority of MRI, there is an obvious disparity between MRI and clinic as well as pathology.

关 键 词：下咽癌 体层摄影术 X线计算机 磁共振成像 

分 类 号：R739.6[医药卫生—肿瘤]