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目的 将横断面图像、多平面重建 (MPR)图像和仿真内窥镜 (VE)图像结合起来综合评价喉部肿瘤的侵犯范围。方法 2 0例拟诊喉及下咽癌的患者行术前前瞻性螺旋CT检查并行图像后处理 (MPR和VE)。采用盲法阅片 ,将横断面图像结果与横断面、MPR、VE联合图像结果分别与手术病理结果对照。结果 联合图像对评价室带、声带、前联合、声门下、甲状软骨、喉外结构受侵的总敏感性、特异性、准确性分别为 :10 0 %、98.5 %、99.2 %,横断面图像分别为 :92 .4%、89.5 %、90 .8%;两者比较其特异性、准确性在统计学上差异有显著性意义 (P值分别为 :0 .0 2 8、0 .0 0 3)。对于杓状软骨、声门旁间隙及会厌前间隙的评价 ,联合图像与横断面图像结果一致。结论 对室带、声带、前联合、声门下、甲状软骨、喉外结构的受侵彩横断面结合MPR和 (或 )VE有助于提高诊断水平 ,对于杓状软骨、声门旁间隙及会厌前间隙 ,目前MPR及VE对诊断尚不能提供更多帮助。
Objective To combine cross-sectional images, multi-planar reconstruction (MPR) images and virtual endoscopy (VE) images to evaluate the extent of throat tumor invasion. Methods A total of 20 patients with suspected laryngeal and hypopharyngeal carcinomas underwent preoperative spiral CT examination with parallel image postprocessing (MPR and VE). The results of the cross-sectional images and the cross-sectional, MPR, and VE images were compared with the results of the surgical pathology, respectively. Results The total sensitivity, specificity, and accuracy of the joint images in evaluating ventricular bands, vocal cords, anterior joints, subglottic, thyroid cartilage, and extra-laryngeal structures were: 100%, 98.5%, 99.2%, cross-sectional images. They were: 92.4%, 89.5%, and 90.8%; their specificity and accuracy were statistically significantly different (P = 0. 0 2 8 and 0. 0 0, respectively). 3). For the evaluation of arytenoid cartilage, paraglottic space and epiglottis space, the joint image was consistent with the cross-sectional image results. Conclusion Invasive transversal cross-sections of the ventricular band, vocal cord, anterior unity, supraglottic, thyroid cartilage, and extralaryngeal junctions combined with MPR and/or VE may help to improve diagnostic levels for arytenoid cartilage, paraglottic space, and epiglottis Before the gap, MPR and VE do not provide more help for diagnosis.