MSCT对下咽癌周围解剖细节侵犯的临床价值  

Clinical Value of MSCT for the Invasion of Anatomical Details Around Hypopharyngeal Cancer

作　　者：邹彩云 嵇洪波 张庆宇[1] 倪婷 储成凤[1] 徐柏林[1] 车子刚[1] ZOU Cai-yun;JI Hong-bo;ZHANG Qing-yu(Department of Radiology,The Affiliated Nanjing Tongren Hospital of Southeast University Medical School,Nanjing 211102,Jiangsu Province,China)

机构地区：[1]东南大学医学院附属南京同仁医院医学影像科,江苏南京211102

出　　处：《中国CT和MRI杂志》2020年第10期17-19,33,共4页Chinese Journal of CT and MRI

基　　金：南京市医学科技发展项目(YKK16262);十三五南京市卫生青年人才培养工程(QRX17207);南京同仁医院院内科研项目(2018E010)。

摘　　要：目的探讨MSCT平扫+增强在下咽癌周围侵犯术前分期的临床价值。方法对42例手术病理证实的下咽癌患者MSCT平扫+增强扫描图像进行分析,分析下咽癌发生部位、周围结构侵犯情况及肿瘤分期。结果梨状窝癌32例(76.2%),环后癌6例(14.3%),咽后壁癌4例(9.5%);T1期4例(9.5%),T2期7例(16.7%),T3期16例(38.1%),T4期15例(35.7%);梨状窝癌容易侵犯杓会厌皱襞(28例)、杓状软骨(23例)、咽后壁(16例)、喉旁间隙(24例)、甲状软骨(21例)、室带(17例)、会厌(19例)、会厌前间隙(21例)、声带(20例)、环后(16例)、口咽(13例)、甲状腺(4例)、颈动脉(3例)等;环后区癌易累及咽后壁(6例)、食管颈段(3例)、椎前筋膜(3例)、环状软骨(2例)、梨状窝(1例)、杓会厌皱襞(1例)、杓状软骨(2例)、声带(1例)、喉旁间隙(1例)等;咽后壁癌侵及梨状窝(3例)、杓会厌皱襞(2例)、口咽(1例)、环后区(1例)、椎前筋膜(1例)、食管颈段(1例)、环状软骨(1例)、杓状软骨(1例)、甲状腺(1例)等。手术证实,35例(83.3%)与术前影像分析高度相符。结论 MSCT平扫+增强能清楚显示下咽癌病灶分期及对周围侵犯范围。Objective To explore the clinical value of plain MSCT scan and contrastenhanced scan in preoperative staging of invasion around hypopharyngeal cancer.Methods The invasion of the surrounding structure of hypopharyngeal cancer and tumor stage in the CT findings of 42 patients with hypopharyngeal cancer confirmed by surgical pathology were analyzed.Results Among 42 patients,there were 32(76.2%)cases with piriform fossa cancer,6(14.3%)cases with post-cricoid region cancer,4(9.5%)cases with posterior hypopharyngeal wall cancer.Based on TNM classification of AJCC,there were 4(9.5%)cases at T1 stage,7(16.7%)cases at T2 stage,16(38.1%)cases at T3 stage and 15(35.7%)cases at T4 stage.Piriform fossa cancer tended to invade arytenoid folds(28 cases),arytenoid cartilage(23 cases),posterior pharyngeal wall(16 cases),parathyroid space(24 cases),parathyroid space(21 cases),ventricle(17 cases),epiglottic space(19 cases),vocal cords(20 cases),posterior circulation(16 cases),oropharynx(13 cases),thyroid(4 cases),carotid artery(3 cases),etc.Post-cricoid region cancer tended to invade posterior pharyngeal wall(6 cases),esophageal neck(3 cases),anterior vertebral fascia(3 cases),cricoid cartilage(2 cases),pyriform fossa(1 case),arytenoid cartilage(2 cases),vocal cords(1 case),parasagittal space(1 case),etc.Posterior pharyngeal cancer tended to invade piriform fossa(3 cases),arytenoid fold(2 cases),oropharynx(1 case),posterior region(1 case),anterior fascia(1 case),esophageal neck(1 case),cricoid cartilage(1 case),thyroid(1 case),etc.According to surgery results,35 cases(83.3%)highly consistent with preoperative image analysis.Conclusion Plain MSCT scan and contrast-enhanced scan can clearly show the stage of hypopharyngeal cancer and range of peripheral invasion.

关 键 词：下咽癌 周围范围 MSCT 临床价值 

分 类 号：R739.63[医药卫生—肿瘤]