The Application Of Multi-slice Helical CT And Image Post-progressing In Laryngeal And Hypopharyngeal Carcinoma

Objective:To evaluate the clinical application of multi-slice helical CT and image post-processing(Multi-Planar Reconstruction,CT Virtual Endoscopy,CT Virtual Endoscopy)in 45 patients with laryngeal and hypopharyngeal carcinoma.Methods:45 patients with laryngeal and hypopharyngeal carcinoma were confirmed by electronic laryngoscope and histopathology,who came from our hospital inpatients from June,2007 to August,2008.All of these patients were performed enhanced scanning,18 of these patients were performed plain scanning before enhanced scanning on Somatom Sensation CT(Siemens Company).Scanning parametes: 120KV,140～210mA,pitch 1.25,slice thickness 5mm,contrast medium ultravist (300mg I/ml 100ml),velocity of ejection 2.5～3.0mL/s,span of scanning is from Roof of nasopharynx to superior aperture of thorax.Thin axial images of 0.75mm were reconstructed with the raw data,then MPR,CTVE,transparent 3D VRT images were reconstructed on Volume Wizard workstation.The value of diagnosis of CT in laryngeal and hypopharyngeal carcinoma were compared with electronic laryngoscope and histopathology respectively.Data of these patients were analyzed by SPSS 11.0 software.Results:Laryngeal and hypopharyngeal carcinoma or affected tissues were demonstrated clearly by axial images combine with post-processing images of multi-slice helical CT.There were 9 patients with supraglottic carcinoma,17 patients with glottic carcinoma,6 patients with transglottic carcinoma and 13 patients with hypopharyngeal carcinoma.More affections in ventricular bands and vocal cord were displayed on MPR images than that of on axial images,More affections in anterior commissure were displayed on axial images than that of on MPR images.More patients with metastasis of lymph node were diagnosed according to axial and MPR images than that of findings of operation.But there were no significantly differences among the CT axial images,MPR images and finds of operation in detecting the affections of epiglottis,aryepiglottic fold,ventricular bands,vocal cord,anterior commissure,paraglotic space,laryngeal cartilage and metastasis of lymph node in patients with laryngeal and hypopharyngeal carcinoma(P＞0.05).Three patients were diagnosed metastasis of lymph node,while which didn't be found in operation. More affections of epiglottis,aryepiglottic fold,ventricular bands,vocal cord,anterior commissure and fissure of glottis were found with electronic laryngoscope than with CTVE imaging.More affections of pyriform sinus,ventricle of larynx and distortion of airway were found with VRT images than with electronic laryngoscope or CTVE images.There were no significantly differences between the electronic laryngoscope and CTVE imaging in detecting,the affections of epiglottis,aryepiglottic fold, ventricular bands,vocal cord,anterior commissure and fissure of glottis(P＞0.05), There were no significantly differences among the electronic laryngoscope,CTVE and VRT imaging in detecting the affections of pyriform sinus,ventricle of larynx and distortion of airway(P＞0.05).Three patients of stegnosised airway with laryngeal and hypopharyngeal carcinoma could be detected with CTVE imaging substituted for electronic laryngoscope from caudal-cranial(C-C) direction.Conclusions:1 Helical CT has more predominances than other examinations in demonstrating the affected extent,the damages of laryngeal cartilages and other tissues aroundding larynx,metastasis in patients with larynx and hypopharynx carcinoma.2 Axial images of Helical CT combine with MPR,CTVE,VRT could demonstrate literally shapes,sizes and metastasis of larynx and hypopharynx carcinoma,which could improve the capability of demonstration and the ratio of accuracy in patients with larynx and hypopharynx carcinoma,and which could afford a efficient method to improve the achievement ratio in restructure the function of throat after accurate removal the larynx and hypopharynx carcinoma.