| Objective To evaluate the clinical values of MPR and VRT postprocessing imagesof MSCT in the diagnosis and the staging of hypopharyngeal cancers.Methods60casesdiagnosed as hypopharyngeal carcinomas were collected from January2011to October2013. All the patients were proved pathologically by operation and fiber opticlaryngoscopy and were examined with64-row with128-slice spiral CT.The precontrastand three-phase contrast helical CT were performed in all the patients. After the scanning,we reconstructed the transverse images with the layer thickness of1.25mm using originaldata received by volume scanning, and transferred the thin-slice images to GE AW4.4workstation for post-processing.The postprocessing images of MSCT were performedincluding multiplannar reconstruction(MPR) and volume rendering technique(VRT). CTtransverse images, transverse images combined with MPR and VRT images were bothcompared with pathology of Laryngoscope and surgery.The analysis result of transverseimages were compared with that of the transverse imgaes combining MPR and VRTimages in the value of the diagnosis of hypopharyngeal cancers, the evaluation of theextents of tumors:such as epiglottis,arytenoid epiglottis plica, vocal cords, chamber,recessus piriformis, preepiglottic space, arytenoid, thyroid cartilage, the lower esophagusand the invasion of surrounding structures,metastatic lymph nodes as well. UsingSPSS17.0statistical software package for data analysis, the statistical methods x2test wasused and we think there are statistically significant differences when P<0.05.Results Of60cases,41cases derived from recessus piriformis,manifesting as theirregular thickening walls of recessus piriformis, and the recessus piriformis becameshallow, narrow, even occlusive.11cases were in the posterior wall of hypopharynx with the posterior wall of hypopharynx thickening and the formation of the soft tissue mass.6cases were back wall carcinoma of hypopharyngeal, with the back wall of hypopharyngealobviously irregular thickening, and there were soft tissue masses in the laryngeal vestibuleand the posterior of arytenoid and cricoid cartilage.2cases were hypopharyngeal epitegumcancer.The masses shown obvious inhomogeneous enhancement in contrast CT scanand arytenoid epiglottis plica thickening in the case of arytenoid epiglottis plicainvolvement with obvious enhancement,which the adjacent soft tissues of tumors wereinvolved were characterized by fat interval fuzzy, adjacent soft tissue compressed andswelling or shifting.That cartilages were involved showed interruption or disppearring ofcartilage continuity, part of cartilage defected,even bone destruction.In this group of cases,18cases had cervical lymph nodes metastases.the lymph nodes were shown more intuitiveand accurate on coronal and sagittal MPR images,with single or multiple enlarged lymphnodes, more than1.0cm in diameter, inhomogeneous density, mostly heterogeneitycircular enhancement, center necrosis area without contrast.We had clear axial images, MPR and VRT images in all cases.Combined with thehelical CT enhanced axial and MPR, VRT images, the charcteristics,location of thetumor,the airway stenosis and the cervical metastatic lymph nodes could be seenclearly.The enhanced images could more clearly present the tumor and the extent oflesion.The venous-phase MPR images demonstrated the neck lymph nodes more clearlythan the axial images. Transverse images combined with MPR and VRT images comparedwith single transverse images had significant statistical differences.Conclusion The enhanced axial images of helical CT combining MPR,VRT imagescan clearly demonstrate the location of hypopharyngeal carcinoma,the extension of tumorand neck metastatic lymph node,and show the airway stenosis degree intuitively, which hasvery important guiding meaning to the operation plan of hypopharyngeal carcinomas. |
PDF Full Text Request