The Three-dimensional Ultrasound Imaging Of Normal Adult Larynx And Laryngeal Cancer

Objective:To investigate the three-dimensional ultrasound（3DUS） imaging methodsand characteristics of the normal adult larynx and laryngeal cancer,and to investigatethe value of three-dimensional ultrasonography in the diagnosis of laryngeal cancer.Methods:81cases of healthy persons and30cases of laryngeal cancer were treatedby PHILIPS IU22color doppler ultrasonic diagnostic instrument with superficiallinear array probe L12-5, superficial three-dimensional volume probe VL13-5.Observe the3DUS imaging characteristic of the larynx (the supraglottic area, theglottis area, subglottic area); explore volume3DUS reconstruction methodology and3DUS imaging advantages in the larynx; analyze the larynx3DUS imaging featuresand the diagnostic value of laryngeal cancers compared with CT/MRI imaging results.Results:(1) The displayed rate of hyoid transverse image of3DUS is better than thatof2DUS in normal adults(P <0.05); the quality of3DUS image of female adults isbetter than that of males in hyoid transverse level,vocal cord and false vocal cordLongitudinal section or transverse section; imaging quality of vocal cord and falsevocal cord gradually decreases both in45-59years old and≥60years old maleadults.(2) Three-dimensional ultrasound volume imaging method: soft tissue structuresclearly showed by A/B mode;bone structure displayed by C, Adjust the imageorientation or rotating module X, Y, Z axis to observe larynx structure frommulti-angle, get the coronal information which2DUS is not easy to get, cut volumemodule by turning Slice layer to display the organization structure and spatialrelationships.(3) Reconstruction by3DUS, Male’s biggest glottis area was (132.82±11.39)mm2;the angle of vocal cords is (43.67±3.51)°;the distance of bilateral vocal process is(12.29±0.89) mm.Female ’s biggest glottis area was (110.04±13.18); the angle ofvocal cords is(42.15±2.65)°;the distance of bilateral vocal process is (11.04±0.76)mm.The measurements of vocal cords angle is not difference between male andfemale.But the measurements of the biggest glottis area,he distance of bilateral vocalprocess and the three parameters of vocal cord in adults were greater than those infemale adults (both P<0.05)．Adult male bilateral vocal cord length, width, thickness were greater than women, P <0.05).(3) CT/MRI,3DUS reconstruction of laryngealcancer primary focal positioning accuracy was93.33%(28/30) and96.67%(29/30).There is no difference between the result of3DUS in combination with2DUS andCT/MRI in T and N staging of laryngeal cancer,P>0.05. The results that3cases ofepiglottis/clearance before epiglottis invasion and1case of subglottic carcinoma ofthyroid cartilage invasion were confirmed by pathology.Conclusions:(1)Normal adult laryngeal three-dimensional ultrasound reconstructionimage is clear, especially the organization behind the skeleton is more clearly than2DUS. On the basis of2DUS，3DUS can display by fine adjustment of the parametersin the technique, especially for laryngeal bone structure and the clear display of thestructure of the glottis area,which make up for the deficiency of the two-dimensionalultrasound.(2)Three-dimensional ultrasound reconstruction of larynx cancer in this study canshow primary tumors, on the surrounding tissue infiltration, combined with2DUSpresence of lymph node metastasis diagnosis,,3DUS reconstruction has an equaldiagnostic value compared with CT/MRI.(3)Volume probe three-dimensional ultrasonic imaging method is simple andconvenient, less skilled relying on operators, repeatable and inexpensive.Combined2DUS with3DUS, it provides an effective, noninvasive examination method forlaryngeal disease diagnosis.