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目的探讨螺旋 CT 多平面重组技术(MPR)在喉癌诊断中的意义。方法 35例拟诊喉癌患者行术前 CT 检查并行 MPR 图像后处理,将横断面、MPR 及横断面联合 MPR 图像诊断结果分别与术后病理切片的病变范围进行对照,应用卡方检验进行统计学处理。结果对前联合受侵的评价,横断面、MPR、横断面联合 MPR 3组图像准确性分别为82.9%、68.6%和91.4%,差异有统计学意义(P<0.05),其中,联合图像优于 MPR 图像(P<0.05)。在评价喉旁间隙受侵方面,3组图像准确性分别为91.4%、68.6%和94.3%,差异有统计学意义(P<0.05),其中,横断面及联合图像准确性均高于 MPR 图像(P 值均<0.05)。3组图像对评价甲状软骨受侵准确性分别为94.3%、77.1%和97.1%,差异有统计学意义(P<0.05),其中,横断面与 MPR 之间,MPR 与联合图像之间差异有统计学意义(P 值均<0.05);对会厌、杓会厌皱襞、声带、室带、会厌前间隙、梨状窝、杓状软骨及喉外受侵的评价,3组图像差异无统计学意义(P>0.05),但横断面联合 MPR 图像对判断各结构受侵具有较高的敏感性、特异性和准确性。结论螺旋 CT 横断面图像能够很好显示肿瘤的形态、大小、侵犯范围及颈部淋巴结转移,MPR 较横断面图像更全面直观地显示肿瘤的形态及范围,是对常规轴面图像的有益补充。横断面联合 MPR 能提高喉癌诊断符合率。
Objective To investigate the significance of spiral CT multiplanar reconstruction (MPR) in the diagnosis of laryngeal cancer. Methods 35 cases of suspected laryngeal cancer patients underwent preoperative CT examination and MPR image post-processing, the cross-sectional, MPR and cross-sectional MPR image diagnosis results were compared with postoperative pathological lesions were compared, using chi-square test for statistics Learn to deal with. Results The accuracy of cross-sectional, MPR and cross-sectional MPR 3 images was 82.9%, 68.6% and 91.4% respectively, with significant difference (P <0.05). The joint images Better than MPR images (P <0.05). The accuracy of the three groups of images was 91.4%, 68.6% and 94.3%, respectively, in evaluating the invasion of laryngeal space (P <0.05). The accuracy of cross-sectional and combined images was higher than that of MPR Images (P <0.05). The accuracy of the three groups of images in assessing the thyroid cartilage invasion was 94.3%, 77.1% and 97.1%, respectively, with significant difference (P <0.05). The difference between the MPR and the joint image was significant (P <0.05). The evaluation of epiglottis, bullous epiglottis, vocal cord, ventricular band, anterior epiglottic space, piriform fossa, arytenoid cartilage and throat invasion showed no statistical difference among the three groups (P> 0.05). However, the cross-sectional joint MPR images have higher sensitivity, specificity and accuracy in judging the invasion of each structure. Conclusions Spiral CT cross-sectional images can show the morphology, size, extent of invasion and cervical lymph node metastasis well. MPR shows the morphology and range of tumor more comprehensively and intuitively than the cross-sectional images, which is a useful supplement to conventional axial images. Cross-sectional joint MPR can improve the diagnostic accuracy of laryngeal cancer.