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題名 | 磁振造影與電腦斷層造影評估喉癌的軟骨侵犯=MRI and CT Evaluation of Cartilage Invasion of Laryngeal Carcinoma |
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作者 | 羅兆寶; 鄧木火; 陳行素; 凌憬峰; 郭萬; 藍功堯; 張政彥; 張遵; | 書刊名 | 中華放射線醫學雜誌 |
卷期 | 22:2 1997.04[民86.04] |
頁次 | 頁67-73 |
分類號 | 414.93、414.93 |
關鍵詞 | 喉電腦斷層; 喉磁振造影; 喉腫瘤; Larynx CT; Larynx MR; Larynx neoplasms; |
語文 | 中文(Chinese) |
中文摘要 | 在過去3年間,我們收集了41例經病理證實為喉癌的病例,並收集病人術前MRI及CT。其中8例病人因幽閉恐佈而無法完成檢查,或躁動致影像模糊而無法判讀外,其餘 33例病人皆於5天內完成MRI及CT檢查,並由神經放射科專科醫師做回溯性判讀。判讀重點為喉部軟骨是否受到腫瘤侵犯。判讀結果與做喉部切除的病理報告做比較。我們發現透明軟骨是否被癌細胞侵犯,MRI的敏感性有89%(32/36),CT為50%(18/36),尤其是在甲狀軟骨,MRI為94% (17/18),CT 只有 39% (7/18),在專一性方面,MRI為91% (87/96),CT為96%(92/96)。MRI對透明軟骨之敏感性明顯較CT高,其原因為MRI有較高之組織對比,CT相反的其組織對比差,在骨化不全或是未骨化的軟骨,CT 難以辨識軟骨是否被癌細胞侵犯。另一方面,CT其專一性較MRI高,其原因為MRI 對軟骨內之異常信號,有可能是非腫瘤所造成的如發炎變化,或是纖維化,這些通常不易與軟骨受到癌細胞侵犯做鑑別診斷。我們認為,如果喉癌病人能合作,檢查過程能儘量保持喉部不動,且能平躺30分鐘而不致有嗆到或窒息之虞, 則 MRI 應是評估喉部軟骨是否被癌細胞侵犯,優先選擇之影像工具。 |
英文摘要 | Forty-one patients who underwent total or partial laryngectomy for laryngeal carcinoma were examined before treatment with magnetic resonance imaging (MRI) and computed tomography (CT) scan. Eight patients were excluded from this study because of motion artifact or claustrophobia.MRI and CT findings of neoplastic cartilage invasion were recorded and correlated with pathological findings. At histological examination, neoplastic cartilage invasion was depicted in 21 patients and was absent in 12. Thirty-two out of 36 neoplastic cartilage invasions were detected by MRI (32/36, sensitivity 89%), and 18 by CT (18/36, sensitivity 50%). MRI mistook 9 normal cartilages for neoplastic invasion (9/96, specificity 91%), and similar overestimation was seen in 4 out of 96 by CT (4/96, specificity 96%). MRI has a higher sensitivity than CT in the detection of neoplastic cartilage invasion because of better tissue contrast. However, MRI cannot distinguish nonneoplastic change in the cartilage from tumor invasion, which creates a potential source of overestimation of cartilage invasion. MRI of the larynx is the radiologic procedure of choice for evaluating neoplastic cartilage invasion for those patients who are cooperative and well enough to undergo the procedure of examination. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。