CT间接淋巴造影诊断舌癌颈淋巴结早期转移  

Indirect computed tomography lymphography for diagnosis of early neck lymph node metastasis in tongue cancer

作　　者：应海岳[1] 吴海涛[2] 

机构地区：[1]宁波市第二医院耳鼻咽喉科,浙江宁波315010 [2]复旦大学附属眼耳鼻咽喉科医院耳鼻咽喉头颈外科,上海200031

出　　处：《温州医科大学学报》2016年第9期660-665,共6页Journal of Wenzhou Medical University

摘　　要：目的:探讨舌癌的早期转移颈淋巴结在CT间接淋巴造影中的特点。方法:健康成年新西兰白兔18只,随机法分成3组,颈淋巴结正常组、增生组及早期转移组各6只;分别于注射前及在舌腹黏膜下注射0.5 m L欧乃派克后1、5、15、20 min行轴位CT扫描,观察3组淋巴结在间接淋巴造影时的不同特点。结果:所有动物在造影整个过程中颌下淋巴结及颈浅淋巴结均未显影,而只有颈深淋巴结在所有动物中均显影,整个显影过程中未见有明显的血管显影。在CT上转移组淋巴结的平均直径为(0.73±0.08)cm,增生组为(0.75±0.10)cm,而正常组为(0.47±0.05)cm,正常组淋巴结大小分别与转移组和增生组淋巴结大小比较差异有统计学意义。转移组淋巴结内造影剂消退缓慢,而增生组及正常组淋巴结内造影剂消退较快;转移组淋巴结表现为充盈缺损、周边凹凸不平、质地不均、毛糙,而增生组及正常组淋巴结质地均匀,周边光滑,无充盈缺损。结论:CT间接淋巴造影对舌癌颈淋巴结早期转移的诊断有一定的特异性,这些特异性有可能作为诊断早期转移淋巴结的指标。Objective： Experimental evaluation of the potential utility of indirect computed tomography lymphography （CT-LG） for detecting early cervical lymph node metastasis in rabbits VX2 tongue cancer model.Methods： Eighteen New-Zealand rabbits were divided into 3 groups randomly, one group were injected egg-yolk emulsion in the neck, one group were transplanted with VX2 tumor tissue mass suspension in the tongue, and the last remained untreated. CT-LG with submucosal injection of 0.5 mL Iohexol in the tongue was performed, followed by postmortem examination of deep cervical lymph nodes. Results： Only deep cervical lymph nodes were enhanced in CT-LG, there was no noticeable enhancement in the blood vessels. The average diameter of metastatic lymph nodes were （0.73±0.08） cm in CT, the hyperplasic group were （0.75±0.10） cm and the normal group were （0.47±0.05） cm. The contrast in metastatic nodes reduced more slowly than normal and hyperplasic nodes with significant difference. Metastatic nodes’ manifestations in CT-LG included filling defect, rugosity in line and heterogeneous while the other two groups appear to be smooth and homogenous. Conclusion： Indirect CT-LG has some advantage in finding out the early neck lymph node metastasis in tongue cancer.

关 键 词：舌癌 VX2瘤 淋巴转移 计算机扫描 间接淋巴造影 兔 

分 类 号：R76[医药卫生—耳鼻咽喉科]