The Value Of Dual-energy CT And MRI In Evaluating The Anterior Commissure Involvement And Preoperative T Staging In Laryngeal Carcinoma

The value of dual-energy CT and MRI in evaluating the Anterior commissure involvement and preoperative T staging in laryngeal carcinomaObjective:To compare and discuss the value of dual-energy CT(DECT)and MRI in evaluating involvement of anterior commissure and preoperative T staging in laryngeal carcinoma.Methods:A total of 62 laryngeal carcinoma patients confirmed by pathological examination from June 2017 to January 2020 were recruited.The clinical and imaging data(preoperative DECT and MRI examinations)of these patients were retrospectively analyzed.The diagnostic efficacy(accuracy,specificity,sensitivity,positive predictive value and negative predictive value)of DECT,MRI and their combination of both imaging methods in evaluating involvement of anterior commissure in laryngeal carcinoma were calculated;Then use dual-energy CT,MRI and the Combined diagnosis to perform preoperative imaging T staging of laryngeal carcinoma,and compare the accuracy of staging of different examination methods to evaluate its diagnostic efficacy.Results:Post-operative pathological examination showed that among 62 patients,35 patients were positive for laryngeal carcinoma with anterior commissure in volvement.The accuracy,sensitivity,specificity,negative predictive value and p ositive predictive value of DECT were 88.57%(31/35),92.59%(25/27),90.32%(56/62),93.94%(31/33)and 86.20%(25/29),respectively,while the diagn ostic efficiency of MRI were 94.29%(33/35),88.89%(24/27)and 91.94%(57/29),respectively,while the diagnostic efficiency of the combined methods were 100.00%(35/35),81.48%(22/27),91.94%(57/62),87.50%(35/40)and 100.00%(22/22),respectively.Diagnosis of anterior commissure involvement in lary ngeal carcinoma:dual-energy CT,MRI,combined diagnosis and postoperative p athology were not statistically different(χ2=1.5,0.0,3.2,P>0.05),consistent with postoperative pathological results High sex(χ2=0.805,0.835,0.832,P<0.01);there is no statistically significant difference between dual-energy CT and MRI(χ2=2.28,P>0.05),among which dual-energy CT and MRI diagnose laryngeal c ancer The positive rates of former joint invasion were 53.2%and 41.9%,respe ctively.The total accuracy of dual-energy CT and MRI in diagnosing structural invasion of laryngeal carcinoma were 99.10%and 97.77%,respectively.In T staging,the accuracy of dual-energy CT in diagnosing stage T1,T2,T3,T4 laryngeal cancer is 91.67%,81.25%,85.71%,92.30%,and MRI is 87.50%,87.50%,85.71%,100.00%.,The total staging accuracy was 88.33%and 90.00%,respectively,and the difference between the two results was statistically significant(x2=127.15,P<0.01).The accuracy of combined diagnosis of stage T1,T2,T3,and T4 laryngeal cancer is 95.83%,93.75%,85.71%,92.30%,and the total accuracy is 93.33%.Compared with the staging of dual-energy CT and MRI alone,there is a difference All were statistically significant(χ2=146.93,146.43,P<0.01).Conclusion:Both DECT and MRI can be use to evaluate involvement of anterior commissure and preoperative imaging T staging in laryngeal carcinoma.The combined imaging methods can further improve the diagnostic efficiency.The accuracy of dual-energy CT in diagnosing stage T1 laryngeal cancer is significantly higher than that of MRI,and the accuracy of MRI in diagnosing stage T2 and T4 laryngeal cancer is slightly higher than that of dual-energy CT.Both have their own advantages and can complement each other.