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目的评价多层螺旋CT(MSCT)横断面及多平面重建(MPR)在颈部恶性肿瘤侵犯颈动脉方面的应用价值。方法对39个与颈动脉贴邻肿物均行MSCT扫描。2位医生进行盲法阅片,在横断面扫描图像上测量肿瘤包绕颈动脉的角度并分组(≥45°组、≥90°组和≥180°组);在MPR图像上测量肿瘤与颈动脉的最大交角并分组(≥45°组和≥90°组),测量肿瘤与动脉交界面长度、肿瘤最大纵径,计算交界面长度与最大纵径的比值并分组(≥05组、≥08组和=10组)。对比手术及病理结果,比较受侵动脉与未受侵动脉在以上方面的组间差异,并进行统计学分析。结果在横断面扫描图像上,≥90°组和≥180°组对颈动脉受侵判断的准确度高于≥45°组(P<005),≥90°组可兼顾敏感度和特异度。MPR上肿瘤和动脉交界面长径与肿瘤最大纵径的比值,≥08组和=10组对颈动脉受侵判断的准确度高于≥05组(P<005),≥08组的敏感度高于=10组(P<005)且特异度与后者相仿(P>005)。MPR上肿瘤与动脉交界面角度≥45°组和≥90°组对颈动脉受侵判断的准确度差异无统计学意义(P>005),而≥90°组可兼顾敏感度和特异度;MPR显示肿瘤与动脉交界面角度≥90°时,受侵动脉明显多于未受侵动脉(P<005)。结论对于颈动脉受侵的判断,横断面上肿瘤包绕颈动脉角度≥90°,在MPR上肿瘤和动脉交界面长
Objective To evaluate the value of multi-slice spiral CT (MSCT) cross-sectional and multiplanar reconstruction (MPR) in the diagnosis of carotid artery invaded by cervical cancer. Methods Thirty-nine carotid artery adjacent masses were scanned by MSCT. Two physicians performed blinded radiographs and measured the angle of the tumor surrounding the carotid artery on a cross-sectional scan (group ≥45 °, ≥90 ° and ≥180 °); measured tumor and neck on MPR images (≥45 ° group and ≥90 ° group), the length of the tumor-artery interface, the maximum longitudinal diameter of the tumor, the ratio of the length of the interface to the maximum longitudinal diameter were calculated and grouped (≥05, ≥08 Group and = 10 groups). Comparing the results of surgery and pathology, we compared the differences between the affected and the uninvolved arteries in the above aspects and conducted statistical analysis. Results The accuracy of carotid artery in ≥90 ° group and ≥180 ° group was higher than that in ≥45 ° group (P <005). The sensitivity and specificity of ≥90 ° group were comparable in the cross-sectional images. The ratio of the long diameter of the interface between tumor and artery to the maximum longitudinal diameter of MPR in MPR group was higher than that of ≥05 group (P0.05), ≥08 group Higher than = 10 groups (P <005) and specificity similar to the latter (P> 005). There was no significant difference in the accuracy of carotid artery invasion between the MPR group and the group of ≥45 ° and ≥90 ° (P> 005), while the sensitivity of ≥90 ° group was comparable to that of the MPO group. When MPR showed that the interface angle of tumor and artery was ≥90 °, the affected artery was significantly more than the non-affected artery (P <005). Conclusions For the judgment of carotid artery invasion, the cross-sectional area of the tumor surrounding the carotid artery is ≥90 °. The interface length between tumor and artery in the MPR